Perioperative medicine & outcomes
A randomised controlled trial of prehabilitation in patients undergoing elective cardiac surgery
Authors' conclusion
The combination of exercise and inspiratory muscle training in a prehabilitation intervention before cardiac surgery was not superior to standard care in improving functional exercise capacity measured by six-minute walk test distance pre-operatively.
Study context
- Population
- Adults awaiting elective cardiac surgery
- Participants
- 180 adults
- Comparison
- Prehabilitation vs standard pre-operative care
- Prehabilitationn = 91
- Primary endpoint
- Change in six-minute walk test distance
- Follow-up
- Baseline to pre-operative assessment
Primary result
As reported in the abstract
Change in six-minute walk test distance, baseline to pre-operative assessment · pre-operative assessment
Not significantly different between groups: mean difference (95%CI −30.6-15.0), p = 0.503
−7.8 m
Secondary outcomes
| Outcome | Mean difference (cmH2 O) (95% CI) | P value | |
|---|---|---|---|
| Change in maximal inspiratory pressure · up to 12 weeks after surgery | 10.6 (4.6–16.6) | P < 0.001 | |
| −1001020Difference, cmH2 O (linear scale) |
Events
| Outcome | Prehabilitation | Standard care |
|---|---|---|
| Postoperative mortality | 1 | 1 |
- Attendance at ≥4 of 8 supervised exercise classes (prehabilitation)
- 71.4% · 65 of 91
- Attendance at ≥4 of 8 supervised exercise classes (prehabilitation) — Age > 50 years vs younger, OR (95%CI) for attendance
- 4.6 (1.0-25.1)
- Change in maximal inspiratory pressure: significantly greater at all time-points; greatest at 12 weeks
Six-minute walk test distance, sarcopenic patients (subgroup)
- Larger improvements amongst sarcopenic patients in the prehabilitation group
- Interaction p = 0.004
Handgrip strength and quality of life · up to 12 weeks after surgery
- No differences
Postoperative mortality
- No significant difference in mortality, surgical or pulmonary complications
Safety
- Related to prehabilitation, of 71 pre-operative adverse events
- six (8.5%)
Original publication
A randomised controlled trial of prehabilitation in patients undergoing elective cardiac surgery. Anaesthesia. Published 4 July 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →