The impact of prehabilitation on post-surgical complications in patients undergoing non-urgent cardiovascular surgical intervention: Systematic review and meta-analysis
| Autor: | Filipe Carvalho Marmelo, Daniel Moreira-Gonçalves, Vânia Rocha |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Surgical stress Heart Diseases Epidemiology medicine.medical_treatment Prehabilitation 030204 cardiovascular system & hematology 03 medical and health sciences Postoperative Complications 0302 clinical medicine Intervention (counseling) Preoperative Care medicine Humans 030212 general & internal medicine Cardiac Surgical Procedures Intensive care medicine Exercise Mechanical ventilation business.industry Standard treatment Recovery of Function Confidence interval Exercise Therapy Cardiac surgery Meta-analysis Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Preventive Cardiology. 25:404-417 |
| ISSN: | 2047-4881 2047-4873 |
| DOI: | 10.1177/2047487317752373 |
| Popis: | Introduction Cardiac surgery is an aggressive procedure, inducing a great level of stress and disturbance to the homeostasis of the organism and underlying several postoperative complications. Surgical prehabilitation comprises pre-operative physical conditioning designed to improve the physiological and functional capacities of the individual, prepare the organism for surgical stress and reduce the risk of postoperative morbidity. Aim This systematic review and meta-analysis is aimed at evaluating the ability of prehabilitation to prevent post-surgical complications in cardiac patients. Methods We selected studies conducted among patients who were waiting for non-urgent cardiac surgical procedures, where a comparison between prehabilitation and standard treatment was made. A total of 3650 possible studies were researched, of which eight were selected for inclusion. Results A reduction in the number of complications in the groups submitted to prehabilitation (odds ratio = 0.41; 95% confidence interval (CI): 0.28–0.62; p 2 = 0%) was observed, as well as a significant increase in maximal inspiratory pressure (standard mean difference (SMD) = 0.66; 95% CI: 0.35–0.96; p 2 = 58%), a non-significant decrease in the length of stay (SMD = –0.56; 95% CI: −1.13, 0.01; p = 0.05; I2 = 93%), a non-significant increase in the distance walked by the intervention group in the six-minute walk test (SMD = 0.89; 95% CI −0.06, 1.84; p = 0.07) and a lack of effect on mechanical ventilation time (SMD = −0.03; 95% CI: −0.22, 0.16; p = 0.75; I2 = 0%). Conclusion Prehabilitation reduces the number of post-surgical complications and increases maximal inspiratory pressure; a reduction in the length of stay and an improvement of functional capacities are also probable. |
| Databáze: | OpenAIRE |
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