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Finding value with prehabilitation in older persons receiving surgery.

Priscilla Ng1, Jin Keat Daniel Lee2, Kok Yang Tan2

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Prehabilitation programs, combining exercise, nutrition, and psychological support, enhance surgical patient function and outcomes. Tailoring these interventions for high-risk individuals optimizes benefits and improves overall value assessment.

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Area of Science:

  • Geriatric Surgery
  • Perioperative Medicine
  • Rehabilitation Science

Background:

  • Surgical patients are increasingly older and frail.
  • Prehabilitation aims to optimize function before surgery to improve outcomes.
  • Existing evidence is limited by small, heterogeneous trials.

Purpose of the Study:

  • To review the evidence for prehabilitation in surgical patients.
  • To identify key considerations for strengthening the value proposition of prehabilitation.
  • To guide future research and clinical implementation.

Main Methods:

  • Systematic reviews and meta-analyses of prehabilitation trials.
  • Analysis of multimodal prehabilitation program components (exercise, nutrition, psychological support).
  • Consideration of patient-centered value assessment, including functional, quality of life, and cost outcomes.

Main Results:

  • Multimodal prehabilitation shows potential for improved function, reduced complications, and shorter hospital stays.
  • Individualized and pragmatic program design is crucial for adherence.
  • Targeting high-risk patients may enhance resource effectiveness.

Conclusions:

  • Multimodal prehabilitation, delivered by multidisciplinary teams, improves functional outcomes post-surgery.
  • Function is a key component of multidimensional value assessment.
  • Future efforts should focus on addressing frailty and overcoming adherence barriers through targeted program design.