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Background <p>Older adults undergoing major abdominal, cardiac, or vascular surgery are highly vulnerable to postoperative complications, prolonged hospitalisation, functional decline, and mortality. Sarcopenia and frailty reduce physiological reserve, underscoring the potential role of prehabilitation in improving resilience to surgical stress and postoperative outcomes.</p> Objective <p>To evaluate the effects of exercise-based prehabilitation, alone or combined with nutritional, psychological, or educational components, on postoperative outcomes, including complications, length of stay, readmissions, mortality, quality of life, and economic indicators, as well as on body composition, functional reserve, and biological markers, in adults aged ≥ 65 years undergoing major abdominal, cardiac, or vascular surgery.</p> Methods <p>Medline, Scopus and EMBASE were searched for Randomised Controlled trials assessing prehabilitation programmes in older adults undergoing major abdominal, cardiac or vascular surgery. Data on study characteristics, interventions, outcomes, and methodological quality were extracted and synthesized narratively.</p> Results <p>Nine studies (<i>n</i> = 36–182; mean/median age 68–82) were included. Interventions lasted 2–6 weeks and involved exercise alone or multimodal programmes, delivered in-person, remotely, or via hybrid approaches. Vascular surgery studies showed modest reductions in complications and hospital stay, whereas abdominal surgery studies generally reported no significant improvements, except for isolated reductions in severe complications or gains in functional reserve. No studies involving cardiac surgery were identified.</p> Conclusion <p>Prehabilitation in older adults remains understudied, especially in frail patients, the oldest old, and cardiac surgery. Robust trials are needed to assess individualized, multimodal, sarcopenia-targeted interventions and to integrate biological markers to clarify underlying mechanisms.</p>

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Effects of prehabilitation programmes on postoperative outcomes in older adults undergoing major abdominal, cardiac or vascular surgery: a systematic review

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月4日

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  • Fanny Buckinx,
  • Anne-Françoise Rousseau,
  • Edouard Louis,
  • Arnaud De Roover,
  • Olivier Detry,
  • Rodolphe Durieux,
  • Sophie Gillain,
  • Abdourahamane Kaba,
  • Jean-François Kaux,
  • Vincent Tchana-Sato,
  • Olivier Bruyère

摘要

Background

Older adults undergoing major abdominal, cardiac, or vascular surgery are highly vulnerable to postoperative complications, prolonged hospitalisation, functional decline, and mortality. Sarcopenia and frailty reduce physiological reserve, underscoring the potential role of prehabilitation in improving resilience to surgical stress and postoperative outcomes.

Objective

To evaluate the effects of exercise-based prehabilitation, alone or combined with nutritional, psychological, or educational components, on postoperative outcomes, including complications, length of stay, readmissions, mortality, quality of life, and economic indicators, as well as on body composition, functional reserve, and biological markers, in adults aged ≥ 65 years undergoing major abdominal, cardiac, or vascular surgery.

Methods

Medline, Scopus and EMBASE were searched for Randomised Controlled trials assessing prehabilitation programmes in older adults undergoing major abdominal, cardiac or vascular surgery. Data on study characteristics, interventions, outcomes, and methodological quality were extracted and synthesized narratively.

Results

Nine studies (n = 36–182; mean/median age 68–82) were included. Interventions lasted 2–6 weeks and involved exercise alone or multimodal programmes, delivered in-person, remotely, or via hybrid approaches. Vascular surgery studies showed modest reductions in complications and hospital stay, whereas abdominal surgery studies generally reported no significant improvements, except for isolated reductions in severe complications or gains in functional reserve. No studies involving cardiac surgery were identified.

Conclusion

Prehabilitation in older adults remains understudied, especially in frail patients, the oldest old, and cardiac surgery. Robust trials are needed to assess individualized, multimodal, sarcopenia-targeted interventions and to integrate biological markers to clarify underlying mechanisms.