Abdominal Surgical Patient, High-risk Patient
Conditions
Keywords
Training, Wellness, Aerobic capacity, Information and communication technology, surgical risk, Abdominal surgery
Brief summary
Despite recent advances, morbidity and mortality associated to major abdominal surgery is significant. A poor physical condition and functional status reduces the ability of a person to cope, mentally and physically, with hospitalization and surgery and may compromise functional recovery, potentially leading to postoperative complications and death. Prehabilitation aims to enhance functional capacity preoperatively for better toleration of surgery and to facilitate recovery and eventually the prognosis of the surgical patient. Whereas the benefits of cardiopulmonary fitness programs are well established, the accessibility, sustainability of effects, and impact on the surgical outcome of these programs are unsolved issues. Wellness programs based on integrated care services supported by Information and Communication Technology (ICT) can overcome such limitations. The investigators hypothesized that a prehabilitation program, inducing beneficial effects on exercise capacity, may improve the surgical outcome in high-risk patients. Moreover, ICT support may contribute to increase the adherence and sustainability of this intervention.
Interventions
BEHAVIORALPrehabilitation
Tailored exercise training program
Sponsors
Hospital Clinic of Barcelona
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients over 70 years-old and/or American Society of Anesthesiologists (ASA) health status class III-IV, with a DASI (Duke Activity Score Index) \<46 points, referred for scheduled major abdominal surgery
Exclusion criteria
* Unstable severe co-morbid disease * Dementia and psychosis, severe mental disorder or substance abuse or dependence * Disabling orthopedic and neuromuscular disease.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The incidence of postoperative complications, classified by Clavien Scale | Time Frame: 30days or the postoperative hospital stay if longer than 30 days |
Secondary
| Measure | Time frame |
|---|---|
| Length of stay | 30 days or the postoperative hospital stay if longer than 30 days |
Other
| Measure | Time frame |
|---|---|
| Mortality | 6 months |
| Training induced enhancement of aerobic capacity : VO2 max, Endurance time, 6 MWT (m) | baseline, after the 4-6 week endurance training program (before surgery), and at 3 and 6 months follow-up |
| Health-related quality of life (SF-36) | at baseline and after the 4-6 week endurance training program(before surgery), and at 3 and 6 months follow-up |
| Analysis of the barriers for the use of communication and information technologies in prehabilitation program | Frame: 6 weeks |
Countries
Spain
Outcome results
None listed