Prehabilitation program in elderly patients: a prospective cohort study

The preoperative period may be an opportune period to optimize the patients’ physical condition with a multimodal preoperative program. The impact of a "prehabilitation" program in elderly patients is discussed. This mono-centre observational cohort study included consecutively 139 patients planned for major abdominal and thoracic surgery: 44 in the control group (age<65) and 95 in the elderly group (age> 65). All patients followed a "prehabilitation" program including exercise training, nutritional optimization, psychological support, and behavior change. Seventeen patients in the control group and 45 in the elderly group completed the study at six months. The 6-minute walk test (6MWT) increased in both groups from the initial evaluation to the last one (median value of 80 m [interquartile range 51] for those under 65 years; 59 m [34] for the older ones; P=0.114). The 6MWT was also similar after one month of prehabilitation for both populations. The rate of postoperative complications was similar in the two groups. Prehabilitation showed equivalence in patients over 65 years of age compared to younger patients in terms of increase in functional capabilities and of postoperative evolution. This multimodal program represents a bundle of care which can benefit the frailer population.

Methods
Medical records.