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Prehabilitation: high-quality evidence is still required

Lobo, Dileep N.; Skořepa, Pavel; Gomez, Dhanwant; Greenhaff, Paul L.

Authors

DILEEP LOBO dileep.lobo@nottingham.ac.uk
Professor of Gastrointestinal Surgery

Pavel Skořepa

Dhanwant Gomez



Abstract

Prehabilitation comprises multidisciplinary healthcare interventions, including exercise, nutritional optimisation, and psychological preparation, which aim to dampen the metabolic response to surgery, shorten the period of recovery, reduce complications, and improve the quality of recovery and quality of life. This editorial evaluates the potential benefits and limitations of and barriers to prehabilitation in surgical patients. The results of several randomised clinical trials and meta-analyses on prehabilitation show differing results, and the strength of the evidence is relatively weak. Heterogeneity in patient populations, interventions, and outcome measures, with a wide range for compliance, contribute to this variation. Evidence could be strengthened by the conduct of large-scale, appropriately powered multicentre trials that have unequivocal clinically relevant and patient-centric endpoints. Studies on prehabilitation should concentrate on recruiting patients who are frail and at high risk. Interventions should be multimodal and exercise regimens should be tailored to each patient's ability with longitudinal measurements of impact.

Citation

Lobo, D. N., Skořepa, P., Gomez, D., & Greenhaff, P. L. (2022). Prehabilitation: high-quality evidence is still required. British Journal of Anaesthesia, https://doi.org/10.1016/j.bja.2022.09.016

Journal Article Type Editorial
Acceptance Date Sep 29, 2022
Online Publication Date Nov 1, 2022
Publication Date Nov 1, 2022
Deposit Date Nov 15, 2022
Publicly Available Date Nov 2, 2023
Journal British Journal of Anaesthesia
Print ISSN 0007-0912
Electronic ISSN 1471-6771
Publisher Elsevier
Peer Reviewed Peer Reviewed
DOI https://doi.org/10.1016/j.bja.2022.09.016
Keywords Anesthesiology and Pain Medicine
Public URL https://nottingham-repository.worktribe.com/output/13744362
Publisher URL https://www.sciencedirect.com/science/article/pii/S0007091222005517?via%3Dihub
Additional Information This editorial is based on a lecture delivered by DNL to the 49th World Congress of the International Society of Surgery in Vienna, Austria, August 2022