Multidisciplinary prehabilitation to improve frailty and functional capacity in high-risk elective surgical patients : a retrospective pilot study

© 2024. The Author(s)..

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 (DAH30) 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) DAH30 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.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:13

Enthalten in:

Perioperative medicine (London, England) - 13(2024), 1 vom: 23. Jan., Seite 6

Sprache:

Englisch

Beteiligte Personen:

Wong, Henry Man Kin [VerfasserIn]
Qi, Ding [VerfasserIn]
Ma, Bosco Hon Ming [VerfasserIn]
Hou, Pik Yi [VerfasserIn]
Kwong, Calvin Ka Woon [VerfasserIn]
Lee, Anna [VerfasserIn]
Prehab Study Group [VerfasserIn]
Lam, Stefanie So Ling [Sonstige Person]
Ting, Terry Ho Yan [Sonstige Person]
Ip, Kenny Wing Moon [Sonstige Person]
Chan, Suet Yi [Sonstige Person]
Tsung, Peggy Pui Kee [Sonstige Person]
Chan, Albert Kam Ming [Sonstige Person]
Lau, Vivian Nga Man [Sonstige Person]
Tang, Maria Wing Sze [Sonstige Person]
Ng, Kelvin Kwok Chai [Sonstige Person]
Yip, Hon Chi [Sonstige Person]
Yee, Chi Hang [Sonstige Person]
Joynt, Gavin Matthew [Sonstige Person]

Links:

Volltext

Themen:

Frailty
Journal Article
Perioperative medicine
Preoperative exercise

Anmerkungen:

Date Revised 26.01.2024

published: Electronic

ClinicalTrials.gov: NCT05668221

Citation Status PubMed-not-MEDLINE

doi:

10.1186/s13741-024-00359-x

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM367534754