Perioperative medicine & outcomes
Immune Modulation by Personalized vs Standard Prehabilitation Before Major Surgery: A Randomized Clinical Trial
Authors' conclusion
In this study, personalized prehabilitation significantly altered the immunome before surgery, dampening inflammatory signaling responses previously implicated in the pathophysiology of key surgical outcomes, including surgical site infections and postoperative neurocognitive decline. These changes were accompanied by improved physical and cognitive function before surgery and decreased postoperative complications.
Study context
- Population
- Patients undergoing major elective surgery at a single academic medical center54 completed
- Participants
- 58 patients
- Comparison
- Personalized vs standard prehabilitation
- Personalizedn = 28
- Standardn = 30reference
- Primary endpoint
- Clinical: cognitive assessments and physical performance (wall squat test, timed-up-and-go test, 6MWT); immunological: major innate and adaptive immune cell frequencies and intracellular signaling responses (47-plex mass cytometry)
Methodological detailsprospective, single-blinded, single-centre, block randomization, June 2020 to September 2022
- Prospective
- Single-blinded
- Single-centre
- Block randomization
- June 2020 to September 2022
Primary result
As reported in the abstract
Physical performance and immune changes, pre vs post prehabilitation (within group)
| Group | Value | 6MWT before prehab, median [IQR] | P (6MWT before vs after) | Immune alterations post vs baseline, AUROC | Immune changes post vs baseline, AUROC |
|---|---|---|---|---|---|
| Personalized | median 546 (IQR 350–728) minutes | 496 [340-619] minutes | P = .03 | 0.88; 0.79-0.97; P < .001 | |
| Standard | 0.63; 95% CI, 0.48-0.78; P = .12 |
Value
Personalizedmedian 546 (IQR 350–728) minutes
Standard— not stated in the abstract
6MWT before prehab, median [IQR]
Personalized496 [340-619] minutes
Standard— not stated in the abstract
P (6MWT before vs after)
PersonalizedP = .03
Standard— not stated in the abstract
Immune alterations post vs baseline, AUROC
Personalized0.88; 0.79-0.97; P < .001
Standard— not stated in the abstract
Immune changes post vs baseline, AUROC
Personalized— not stated in the abstract
Standard0.63; 95% CI, 0.48-0.78; P = .12
Safety
Events
| Outcome | Personalized | Standard | P value |
|---|---|---|---|
| Moderate-to-severe postoperative complications (Clavien-Dindo grade >1) | 4 | 11 | P = 0.04 |
Original publication
Immune Modulation by Personalized vs Standard Prehabilitation Before Major Surgery: A Randomized Clinical Trial. JAMA Surg. Published 1 January 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →