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Gerofit Prehabilitation Pilot Program: Preparing Frail Older Veterans for Surgery
Summary
Prehabilitation programs can improve surgical outcomes for older Veterans. This pilot study showed enhanced fitness and better postoperative results, paving the way for a national rollout.
Area of Science:
- Gerontology
- Geriatric Surgery
- Quality Improvement
Background:
- Older Veterans face high risks of surgical complications and death.
- Prehabilitation aims to improve patient health before surgery to enhance outcomes.
- Existing Veterans Affairs (VA) Gerofit programs provide a foundation for prehabilitation.
Purpose of the Study:
- To pilot a prehabilitation program for older Veterans undergoing surgery.
- To assess the feasibility and impact of prehabilitation on fitness and postoperative outcomes.
- To plan for national expansion of a VA prehabilitation quality improvement initiative.
Main Methods:
- Pilot patients were screened for surgical risks and functional decline.
- Baseline physical function was assessed for personalized exercise prescription.
- Patients participated in a prehabilitation program before hospital admission.
Main Results:
- Nine patients completed an average of 17.7 prehabilitation sessions.
- Over 55% of participants improved in at least two fitness assessments.
- Postoperative outcomes (complications, mortality, readmissions) were better than predicted.
Conclusions:
- Prehabilitation is a viable strategy to optimize surgical care for frail, older Veterans.
- The pilot demonstrates positive impacts on fitness and postoperative results.
- Institutional support is secured for a national, multi-institutional prehabilitation program within the VA.
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