Starting a surgical prehabilitation program: results from a pragmatic nonrandomized feasibility study.
Ian M Randall1,2, Darren Au3, Daniel Sibley3,4
1Department of Anesthesia and Pain Management, University Health Network, Toronto, ON, Canada. ian.randall@uhn.ca.
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|November 6, 2024
Summary
Multimodal prehabilitation is feasible as an integrated surgical service, improving patient outcomes. Further studies are needed to confirm its effectiveness in Canada.
Area of Science:
- Gerontology
- Surgical Oncology
- Rehabilitation Medicine
Background:
- Prehabilitation services are increasingly recognized for their potential to optimize patient outcomes before surgery.
- Implementing prehabilitation as an ancillary surgical service requires assessment of its feasibility and impact.
Purpose of the Study:
- To assess the feasibility of a multimodal prehabilitation service integrated into surgical care.
- To estimate the effects of prehabilitation on patient outcomes, including physical and psychological health.
Main Methods:
- A pragmatic, nonrandomized feasibility study involving patients referred for prehabilitation.
- Individualized programs included preoperative exercise, nutrition, psychological support, and smoking cessation.
- Outcomes measured operational feasibility, surgical complications, hospital stay, readmission, quality of life, and health status.
Main Results:
- 116 patients were referred, with 83 participating; mean age 71 years, 55% male.
- Referrals primarily from surgical oncology for frailty.
- Clinically important improvements in patient outcomes were observed from baseline to pre-surgery, returning to baseline by 90 days post-surgery.
Conclusions:
- Multimodal surgical prehabilitation is feasible as an integrated clinical service.
- The intervention shows potential for improving physical and psychological outcomes.
- Further evaluation of integrated prehabilitation programs in Canada is warranted.
