Promoting postoperative recovery in older adult surgical patients: a randomized controlled trial of MDT-based
Qi An1, Yonghao Li2,3, Jinxin Shi1
1Department of General Surgery, Gastrointestinal Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Background:
Traditional perioperative care is hospital-centric, whereas the efficacy of multidisciplinary team (MDT)-based comprehensive nutrition management remains debated. This study examines how this model impacts postoperative complications and functional recovery in older adults.
Methods:
A single-center superiority randomized controlled trial (RCT; April 2023-March 2024) randomized 120 older adults (≥65y) undergoing major abdominal surgery (grades 3-4) into intervention (n = 60) and control (n = 60) groups, excluding those with severe organ dysfunction or poor compliance. The MDT-based model included personalized exercise, nutrition, psychological support (3 weekly sessions, smoking/alcohol cessation), and post-discharge monitoring via wearables/WeChat. Control group received standard care.
Results:
Among 120 participants (mean age 72.6 years; 65.2% male), 5 were lost to follow-up, leaving 56 in the intervention group and 59 in the control group for analysis. The intervention group demonstrated significantly lower postoperative complications compared to controls, with a relative reduction in in-hospital events and lower post-discharge rates (3.6% vs. 6.8%). The Comprehensive Complication Index averaged 6.2 points lower in the intervention group (p = 0.175). Body composition improved significantly, showing reduced weight loss, reduced BMI loss, and increased appendicular skeletal muscle mass index. Postoperative hospital stay was shortened by a median of 3.67 days in the intervention group, which also reported higher rates of mobility improvement and pain relief (all p < 0.05).
Conclusion:
The MDT-based perioperative model synergistically reduces postoperative complications and accelerates geriatric functional recovery through nutritional, exercise, and psychological interventions, providing evidence-based support for high-risk elderly care.
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