Key result
A multidisciplinary prehabilitation program for high-risk surgical patients was feasible and safe, achieving a 75% recruitment rate, 96.3% adherence rate, and zero adverse events.
Why the study?
Frailty is associated with worse outcomes and higher healthcare costs, making the surgical waiting period a potential window to evaluate the feasibility and safety of prehabilitation in high-risk frail patients.
Does multidisciplinary prehabilitation improve feasibility, safety, and functional capacity in high-risk elective surgical patients?
Observational (n=54)
Unblinded
No
Does multidisciplinary prehabilitation improve feasibility, safety, and functional capacity in high-risk elective surgical patients?
A multidisciplinary prehabilitation program is feasible and safe for high-risk patients undergoing major elective surgery, potentially improving functional mobility and nutritional intake.
Feasibility data support prehabilitation trials in high-risk surgery; leaves open outcome benefits in randomized studies.
Background Frailty is associated with worse outcomes and higher healthcare costs. The long waiting time for surgery is a potential ‘teachable’ moment. We examined the feasibility and safety of a pilot prehabilitation programme on high-risk frail patients undergoing major elective surgery. Methods A single-centre, retrospective pilot study (Dec 2020–Nov 2021) on a one-stop prehabilitation programme (structured exercise training, nutritional counselling/therapy, and psychological support) in collaboration with geriatricians and allied health professionals. At least 4 weeks before surgery, patients at high risk of frailty or malnutrition, or undergoing major hepatectomy, esophagectomy, pancreaticoduodenectomy, or radical cystectomy, were referred for prehabilitation (2–3 sessions/week). The primary outcomes were the feasibility and safety of prehabilitation. The secondary outcomes were changes in functional, emotional, and nutritional status and days alive and at home within 30 days after surgery (DAH 30 ) associated with prehabilitation. Results Over a 12-month period, 72 out of 111 patients (64.9%) from the Perioperative Medicine Clinic were eligible for prehabilitation, of which 54 (75%) were recruited. The mean (standard deviation) age was 71.9 (6.9) years. The adherence rate to 3 weeks of prehabilitation was high in 52 (96.3%) participants. Prehabilitation improved exercise capacity ( P = 0.08), enhanced some functional mobility measures ( P = 0.02), and increased nutritional energy ( P = 0.04) and protein intakes ( P < 0.01). However, prehabilitation-related changes in muscle strength, cognitive function, and emotional resilience were minimal. The median (interquatile range) DAH 30 was 19 (14–23) days. No adverse events were reported. Conclusions This outpatient-based, one-stop multidisciplinary prehabilitation programme was feasible, safe, and improved several measures of patient’s physiological reserve and functional capacity. Clinical trial registration NCT05668221.
No takes yet. Share an insight, caveat, or question.
Wong et al. (2024) conducted an observational in High-risk elective surgical patients (n=54). Multidisciplinary prehabilitation was evaluated on Adherence to prehabilitation. A multidisciplinary prehabilitation program for high-risk surgical patients was feasible and safe, achieving a 75% recruitment rate, 96.3% adherence rate, and zero adverse events.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: