Michael R Kann, Emily Estes, Sangami Pugazenthi, Awinita Barpujari, Vamsi Mohan, James L Rogers, Jayanth A Kashyap, Angela Hardi, Christopher S Graffeo
{"title":"The Impact of Surgical Prehabilitation on Postoperative Patient Outcomes: A Systematic Review.","authors":"Michael R Kann, Emily Estes, Sangami Pugazenthi, Awinita Barpujari, Vamsi Mohan, James L Rogers, Jayanth A Kashyap, Angela Hardi, Christopher S Graffeo","doi":"10.1016/j.jss.2024.11.024","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Prehabilitation (preoperative rehabilitation) encompasses a range of patient health driven interventions with the potential to enhance surgical outcomes. This systematic review aims to assess the efficacy of prehabilitation on postoperative outcomes across surgical specialties, focusing on physical functionality and postoperative length of stay (LOS).</p><p><strong>Methods: </strong>Medline, Embase, CINAHL Plus, Cochrane Library, Scopus, and Clinicaltrials.gov databases were queried using the search terms prehabilitation, surgery, and related synonyms. Included publications were original, English-language, full-text studies conducted in the US with a cohort of ≥5 patients undergoing prehabilitation. After title (n = 1817), abstract (n = 1059), and full-text (n = 411) screens, 26 articles met inclusion criteria.</p><p><strong>Results: </strong>Of 26 included articles, 30.8% (n = 8) assessed oncologic surgeries, 34.6% (n = 9) assessed orthopedic surgeries, 19.2% (n = 5) assessed general surgery procedures, and 15.4% (n = 4) assessed cardiac, colorectal, urologic, and transplant surgeries. Physical function was the most common assessed primary outcome, with 46.2% (n = 12) of studies measuring physical activity, functional status, range of motion, or muscle strength. The outcomes of six-meter walk test, sit-to-stand test, and LOS were reported in 26.9% (n = 7), 23.1% (n = 6), and 19.2% (n = 5) of studies, respectively. Three studies found a significant improvement in the six-meter walk test, and four studies demonstrated a significant improvement in sit-to-stand test after prehabilitation. LOS outcomes had varied results across studies.</p><p><strong>Conclusions: </strong>Prehabilitation interventions have the potential to improve postoperative outcomes, including physical function and LOS in surgical patients. Further research is necessary to identify the most efficacious prehabilitation protocols and determine their optimal impact within diverse surgical subpopulations.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"165-181"},"PeriodicalIF":1.8000,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Surgical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jss.2024.11.024","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Prehabilitation (preoperative rehabilitation) encompasses a range of patient health driven interventions with the potential to enhance surgical outcomes. This systematic review aims to assess the efficacy of prehabilitation on postoperative outcomes across surgical specialties, focusing on physical functionality and postoperative length of stay (LOS).
Methods: Medline, Embase, CINAHL Plus, Cochrane Library, Scopus, and Clinicaltrials.gov databases were queried using the search terms prehabilitation, surgery, and related synonyms. Included publications were original, English-language, full-text studies conducted in the US with a cohort of ≥5 patients undergoing prehabilitation. After title (n = 1817), abstract (n = 1059), and full-text (n = 411) screens, 26 articles met inclusion criteria.
Results: Of 26 included articles, 30.8% (n = 8) assessed oncologic surgeries, 34.6% (n = 9) assessed orthopedic surgeries, 19.2% (n = 5) assessed general surgery procedures, and 15.4% (n = 4) assessed cardiac, colorectal, urologic, and transplant surgeries. Physical function was the most common assessed primary outcome, with 46.2% (n = 12) of studies measuring physical activity, functional status, range of motion, or muscle strength. The outcomes of six-meter walk test, sit-to-stand test, and LOS were reported in 26.9% (n = 7), 23.1% (n = 6), and 19.2% (n = 5) of studies, respectively. Three studies found a significant improvement in the six-meter walk test, and four studies demonstrated a significant improvement in sit-to-stand test after prehabilitation. LOS outcomes had varied results across studies.
Conclusions: Prehabilitation interventions have the potential to improve postoperative outcomes, including physical function and LOS in surgical patients. Further research is necessary to identify the most efficacious prehabilitation protocols and determine their optimal impact within diverse surgical subpopulations.
期刊介绍：
The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories.
The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.
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