Prehabilitation of elderly frail or pre-frail patients prior to elective surgery (PRAEP-GO): study protocol for a randomized, controlled, outcome assessor-blinded trial
Creators: name: Schaller, Stefan J.
name: Kiselev, Jörn
name: Loidl, Verena
name: Quentin, Wilm
name: Schmidt, Katrin
name: Mörgeli, Rudolf
name: Rombey, Tanja
name: Busse, Reinhard
name: Mansmann, Ulrich
name: Spies, Claudia
name: Marschall, Ursula
name: Eckardt-Felmberg, Rahel
name: Landgraf, Irmgard
name: Schwantes, Ulrich
name: Busse, Reinhard
name: Mansmann, Ulrich
name: Borchers, Friedrich
name: Mörgeli, Rudolf
name: Schönenberger, Eva
name: Klassen, Philipp
name: Kleikamp, Bernadette
name: Brandhorst, Philipp
name: Spiegel, Anna-Lena H.
name: Papenfuß, Bernhard
name: Dowideit, Jens
name: Oefele, Caroline
name: Gebhardt, Volker
name: Zappel, Kristina
name: Gövercin, Mehmet
name: König, Thomas
name: Chesi, Claudio
name: Reißhauer, Anett
name: Rosada, Adrian
name: Müller-Werdan, Ursula
name: Heymann, Anja
name: Hanke, Marion
name: Leymann, Jens
name: Saller, Thomas
name: Bischof, Ann-Cathrin
name: Reisner, Angelika
name: Albrecht, Wolf Leopold
name: Wojciechowski, Julia
name: Schuldt, Martina
name: Baum, Michael
name: Brnabic, Dijana
name: Pickardt, Björn Von
name: Deutschmann, Agnieszka
name: Scholz, Carsten
name: May, Lars
name: Eckardt-Felmberg, Rahel
name: Wenghöfer, Isabell
name: Blobner, Manfred
name: Sattari, Sima
name: Dummert, Michael
name: Nau, Carla
name: Otto, Mareike
name: Voß-Lümers, Ute
name: Lang, Danny
name: Wiggert, Daniel
name: PRAEP-GO Consortium
name: PRAEP-GO Investigators
Publisher: name: Charité - Universitätsmedizin Berlin
Year: 2022
Subjects: subject: Frail elderly
subject: Preoperative exercise
subject: Frailty
subject: Perioperative care
subject: Health services research
subject: Decision-making
subject: Shared
subject: Randomized controlled trial
subject: 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit

description: Background: Frailty is expressed by a reduction in physical capacity, mobility, muscle strength, and endurance. (Pre-) frailty is present in up to 42% of the older surgical population, with an increased risk for peri- and postoperative complications. Consequently, these patients often suffer from a delayed or limited recovery, loss of autonomy and quality of life, and a decrease in functional and cognitive capacities. Since frailty is modifiable, prehabilitation may improve the physiological reserves of patients and reduce the care dependency 12 months after surgery. Methods: Patients &gt;= 70 years old scheduled for elective surgery or intervention will be recruited in this multicenter, randomized controlled study, with a target of 1400 participants with an allocation ratio of 1:1. The intervention consists of (1) a shared decision-making process with the patient, relatives, and an interdisciplinary and interprofessional team and (2) a 3-week multimodal, individualized prehabilitation program including exercise therapy, nutritional intervention, mobility or balance training, and psychosocial interventions and medical assessment. The frequency of the supervised prehabilitation is 5 times/week for 3 weeks. The primary endpoint is defined as the level of care dependency 12 months after surgery or intervention. Discussion: Prehabilitation has been proven to be effective for different populations, including colorectal, transplant, and cardiac surgery patients. In contrast, evidence for prehabilitation in older, frail patients has not been clearly established. To the best of our knowledge, this is currently the largest prehabilitation study on older people with frailty undergoing general elective surgery.