Comparative Analysis Of Prehabilitation And Standard Care In Improving Surgical Outcomes

Abstract

A limited number of studies have investigated the impact that multimodal prehabilitation has on the potential complications that may emerge after upper abdominal procedures. The purpose of this research is to acquire and assess data from randomised controlled trials that investigated the effects of multimodal prehabilitation on hospital and patient outcomes. The databases MEDLINE, Embase, CINAHL, and Cochrane CENTRAL were searched in a methodical manner in order to find studies that used prehabilitation prior to elective abdominal procedures that were not considered to be emergencies. The studies were analysed, data was collected, and the quality of the trials was evaluated by two different reviewers. Postoperative pulmonary complications (PPCs) and overall issues were the primary outcomes of interest, whereas the duration of stay in the critical care unit and the amount of time spent in the hospital were secondary outcomes. In order to conduct a comparative study, we made use of random-effects models. Additionally, in order to assess heterogeneity, we used the I-square statistic and the Cochran's Q test. The usage of log-odds ratios was used for dichotomous outcomes, while mean differences were employed for the purpose of describing continuous outcomes. This study took into consideration a total of ten studies, which included a total of 1,503 patients. The findings of the study indicated that the prehabilitation group exhibited a significantly decreased risk of postoperative complications when compared to the control groups (-0.38 [-0.75 to -0.004], P= 0.048). According to the findings of five studies that investigated postpartum depression (PPC), it was shown that individuals who had undergone prehabilitation had significantly decreased probability of acquiring PPCs (−0.96 [− 1.38 to − 0.54], P< 0.001). The inclusion of exercise in the prehabilitation program resulted in a significant reduction in the length of hospital stays, despite the fact that this reduction was not consistently seen (− 0.91 [− 1.67 to − 0.14], P= 0.02). There is a lack of clarity on the overall impact that multimodal prehabilitation has on the length of time spent in the hospital after upper abdominal surgery; nevertheless, it has the ability to reduce the risk of problems. There is a disparity in the existing body of literature, which has to be addressed in further research.