A preoperative supervised exercise program potentially improves long-term survival after elective abdominal aortic...

Area of Science:

• Cardiovascular Surgery
• Exercise Physiology
• Critical Care Medicine

Background:

• Preoperative supervised exercise programs (SEP) enhance cardiorespiratory fitness and perioperative outcomes in abdominal aortic aneurysm (AAA) repair patients.
• Previous studies showed improved short-term complication rates with SEP.

Purpose of the Study:

• To evaluate the long-term survival impact of a preoperative SEP in patients undergoing elective AAA repair.
• To assess long-term changes in cardiorespiratory fitness and quality of life post-intervention.

Main Methods:

• Randomized controlled trial comparing a 6-week preoperative SEP to standard care for AAA repair patients.
• Follow-up to 5 years, with all-cause mortality as the primary outcome.
• Intention-to-treat (ITT), per-protocol (PP), and complier average causal effect (CACE) analyses were performed.

Main Results:

• ITT analysis showed a trend towards reduced mortality in the SEP group (P=0.08).
• PP analysis revealed a significant survival benefit for SEP attendees (P=0.01).
• CACE analysis confirmed a significant intervention effect on mortality (HR 0.36, P=0.02). No significant differences in fitness or quality of life were observed long-term.

Conclusions:

• Attending a preoperative SEP offers a significant long-term survival advantage for patients undergoing elective AAA repair.
• The mechanisms driving this mortality benefit warrant further investigation.