Prehabilitation or preadaptation is a concept which consists of preparing patients for surgery or treatment, in order to optimize their physical, physiological, metabolic and psychological capacities, before the intervention. The approach thus focuses on modifiable risk factors, allowing patients, through the promotion of healthy behaviors and the prescription of multimodal and personalized programs, to obtain better results. Thus, prehabilitation programs include adapted exercise practice, nutritional advicepatient education, pain management and psychological support… This “preadaptation” can also include stopping smoking, reducing alcohol consumption, de-prescribing in the case of polypharmacy and measures lifestyle measures aimed at reducing the progression of pre-existing chronic diseases, such as anemia or diabetes.
Thus, the implementation of such preoperative nutrition program across the American health system, appears to enable an 18% reduction in hospitalization days and a 33% reduction in postoperative complications in several surgical specialties. These preoperative nutritional interventions notably make it possible to reduce “aberrant days” of hospitalization, which contributes significantly to savings.
The study analyzed data associated with 4,078 surgical cases spanning 8 surgical specialties and assessed the impact of preoperative nutrition on long-term hospitalization and complication rates. The analysis reveals:
- an average reduction of 18% in length of hospitalization;
- a 33% reduction in complications;
- which results in a considerable reduction in “aberrant days”, that is to say beyond the average duration of hospitalization;
- which also translates into savings amounting to millions of dollars.
A preoperative nutrition program improves patient outcomes,
while also providing enormous savings potential for our health systems, according to this new study which highlights the importance of using nutrients to support the immune system before an intervention to reduce the length of hospitalization and reduce complications.
One of the lead authors, Edward A. Joseph, a cancer clinical practice fellow at the Allegheny Health Network (AHN, Pittsburgh) notes that “Integrating preoperative nutrition as an integral part of surgical care may enable this significant reduction in healthcare utilization. This nutritional support should be considered “routine” during the preoperative period with two objectives: to accelerate the patient’s recovery and to reduce costs for health systems.
There are nutritional kits composed of immunonutrition “shakes” rich in omega-3 fatty acids and argininenutrients that support immune health and surgical recovery. Before surgery, this nutritional package helps patients “fill up on carbohydrates”which also optimizes the patient’s well-being before and after surgery. These nutritional programs, previously mainly used for certain cancer patients in the past, should now be accessible to more surgical patients.
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