Journal Article

Comparative study using propensity score matching analysis in patients undergoing surgery for colorectal cancer with or without multimodal prehabilitation

Lacerda-Filho, Antônio, Estrada, Daniel Mauricio Londoño, de Queiroz, Fábio Lopes, Guerra, Luiza Iannotta, Coelho, Jose Marcos, França-Neto, Paulo Rocha, de Miranda Silvestre, Simone Chaves

2023

Overview

Introduction The complication rate after major abdominal surgery is from 35 to 50%. The multimodal prehabilitation covers all the pre-operative problems to guarantee a faster recovery and reduce the rate of morbidity and mortality after a colorectal procedure. Methods Observational study, in patients with CRC who underwent surgical treatment between November 2020 and September 2022. The data of the patients were placed in 2 groups: prehabilitation group (PPH) and no prehabilitation group (NPPH). Demographic data, type of cancer, operative data, and postoperative data were collected. Characteristics between the groups were compared after a propensity score matching (PSM) analysis for the detection of differences. Results After the PSM analysis, 46 patients were in PPH, and 63 patients were in NPPH. There was no significant difference in postoperative complications ( p  = 0.192). The median of comprehensive complication index (CCI) was 0 ( p  = 0.552). Patients in the NPPH had more hospital readmissions ( p  = 0.273) and more emergency room visits ( p  = 0.092). Multivariate log binomial regression adjusted for complications showed that pre-habilitation reduces the risk of a pos-operative complication (OR: 0.659, 95%CI, 0.434–1.00, p  = 0.019). Conclusions The postoperative complication rate and LOS were similar between patients who receive operative multimodal prehabilitation for CRC surgery and those who did not. Prehabilitation was associated with reduced risk of postoperative complication after multivariate log binomial regression adjusted for complications. Patients who underwent prehabilitation had a slightly lower tendency for postoperative ER visits and hospital readmissions.

• Publisher: Springer Berlin Heidelberg,Springer,Springer Nature B.V
• Subject: Abdominal surgery / Anxiety / Cancer / Cancer patients / Care and treatment / Chi-square test / Colorectal cancer / Colorectal carcinoma / Colorectal Neoplasms - surgery / Colorectal surgery / Comparative analysis / Complications / Emergency medical care / Emergency medical services / Exercise / Gastroenterology / Health aspects / Hepatology / Hospitals / Humans / Internal Medicine / Intervention / Medicine / Medicine & Public Health / Mental depression / Morbidity / Mortality / Normal distribution / Nutrition / Nutritionists / Oncology, Experimental / Patient Readmission / Patients / Physical fitness / Physical therapy / Postoperative / Postoperative Complications - etiology / Postoperative Complications - prevention & control / Preoperative Exercise / Proctology / Propensity Score / Psychologists / Python / Recovery (Medical) / Surgery / Variables