Randomized Multicenter Trial of Multimodal Prehabilitation to Reduce Complications and Costs After Major Surgery in Frail Elderly Patients

What this Trial Is About

The trial investigates the effects of a multimodal, multidisciplinary prehabilitation program designed to reduce complications and increase cost effectiveness after major surgery in elderly, frail patients. It focuses on patients aged 65 and older who often experience higher rates of postoperative complications, longer recoveries, and decreased physiological and functional capacity. The study also considers cancer patients with reduced functional health after treatment as potential beneficiaries of the program. Participants are randomly assigned to one of two groups a control group receiving standard perioperative care based on established ERAS guidelines, and an intervention group undergoing a prehabilitation program. This program includes exercise training, nutritional support, anemia correction, and smoking cessation tailored by a multidisciplinary team. The program is implemented for a minimum of two weeks and up to four weeks before surgery. During the study, participants undergo assessments such as cardio-pulmonary exercise testing, grip strength measurement, nutritional risk evaluation, and questionnaires on recovery and anxiety. Researchers monitor outcomes including the comprehensive complication index 30 days after surgery, physical and nutritional parameters, smoking behavior, hemoglobin levels, days spent at home within 30 days post-surgery, and quality of recovery. The trial runs until December 2026, with detailed monitoring before and after surgery to evaluate the programs impact.

Multimodal Prehabilitation for Surgery in the Elderly: a Randomised, Prospective, Multicenter, Multidisciplinary Trial