Perioperative medicine & outcomes
Relative efficacy of prehabilitation interventions and their components: systematic review with network and component network meta-analyses of randomised controlled trials
Authors' conclusion
Consistent and potentially meaningful effect estimates suggest that exercise prehabilitation, nutritional prehabilitation, and multicomponent interventions including exercise may benefit adults preparing for surgery and could be considered in clinical care.
Study context
- Population
- Adults preparing for major surgery
- Participants
- 15,684 adults · 186 RCTs
- Comparison
- Prehabilitation interventions vs usual care
- Outcome
- Postoperative complications
Methodological detailsrandom-effects network meta-analysis, component network meta-analysis, Confidence in Network Meta-Analysis (CINeMA) certainty assessment
- Random-effects network meta-analysis
- Component network meta-analysis
- CINeMA certainty assessment
Pooled result
As reported in the abstract
Each group vs usual careOdds ratio (95% CI)
Exercise
0.50(0.39–0.64)
Nutritional
0.62(0.50–0.77)
Exercise + nutrition + psychosocial
0.64(0.45–0.92)
Further pooled results
| Outcome | MD (days) (95% CI) | |
|---|---|---|
| LOSExercise + psychosocial vs Usual care · very low certainty of evidence | −2.44 (−3.85 to −1.04) | |
| LOSExercise + nutrition vs Usual care · moderate certainty of evidence | −1.22 (−2.54 to 0.10) | |
| LOSExercise vs Usual care · very low certainty of evidence | −0.93 (−1.27 to −0.58) | |
| LOSNutritional vs Usual care · very low certainty of evidence | −0.99 (−1.49 to −0.48) | |
| −4−202Difference, days (linear scale) |
| Outcome | Mean difference (95% CI) | |
|---|---|---|
| Health related quality of life (Short Form-36 physical component scale)Exercise + nutrition + psychosocial vs Usual care · very low certainty of evidence | 3.48 (0.82–6.14) | |
| −50510Difference (linear scale) |
| Outcome | Mean difference (meters) (95% CI) | |
|---|---|---|
| Physical recovery (six min walk test)Exercise + nutrition + psychosocial vs Usual care · very low certainty of evidence | 43.43 (5.96–80.91) | |
| −50050100Difference, meters (linear scale) |
Individual components (component network meta-analysis)
- Exercise and nutrition were the components most likely to improve all critical outcomes
- Certainty generally low to very low (risk of bias, imprecision); exercise and nutrition results robust to exclusion of high risk of bias trials
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Relative efficacy of prehabilitation interventions and their components: systematic review with network and component network meta-analyses of randomised controlled trials. BMJ. Published 22 January 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →