The Role of Surgical Prehabilitation During the COVID-19 Pandemic and Beyond

Tracey L Hunter; Danielle L Sarno; Oranicha Jumreornvong; Rachel Esparza; Laura E Flores; Julie K Silver

doi:10.1016/j.pmr.2023.03.002

The Role of Surgical Prehabilitation During the COVID-19 Pandemic and Beyond

Phys Med Rehabil Clin N Am. 2023 Aug;34(3):523-538. doi: 10.1016/j.pmr.2023.03.002. Epub 2023 Apr 4.

Authors

Tracey L Hunter¹, Danielle L Sarno², Oranicha Jumreornvong³, Rachel Esparza⁴, Laura E Flores⁵, Julie K Silver⁶

Affiliations

¹ Department of Physical Medicine and Rehabilitation, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Spaulding Rehabilitation Hospital, 300 First Avenue, Charlestown, MA 02129, USA; Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Electronic address: thunter@mgh.harvard.edu.
² Department of Physical Medicine and Rehabilitation, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Spaulding Rehabilitation Hospital, 300 First Avenue, Charlestown, MA 02129, USA; Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Electronic address: https://twitter.com/DanielleSarnoMD.
³ Department of Physical Medicine and Rehabilitation, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mount Sinai Hospital, 1468 Madison Avenue, New York, NY 10029, USA.
⁴ Department of Physical Medicine and Rehabilitation, McGaw Medical Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Shirley Ryan Ability Lab (Formerly the Rehabilitation Institute of Chicago), 355 East Erie Street, Chicago, IL 60611, USA. Electronic address: https://twitter.com/RachelEsparzaMD.
⁵ College of Allied Health Professions, University of Nebraska Medical Center, 42nd and Emile, Omaha, NE 68198, USA. Electronic address: https://twitter.com/LauraFlowersE.
⁶ Department of Physical Medicine and Rehabilitation, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Spaulding Rehabilitation Hospital, 300 First Avenue, Charlestown, MA 02129, USA; Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Electronic address: https://twitter.com/JulieSilverMD.

Abstract

The challenging circumstances of the COVID-19 pandemic caused a regression in baseline health of disadvantaged populations, including individuals with frail syndrome, older age, disability, and racial-ethnic minority status. These patients often have more comorbidities and are associated with increased risk of poor postoperative complications, hospital readmissions, longer length of stay, nonhome discharges, poor patient satisfaction, and mortality. There is critical need to advance frailty assessments to improve preoperative health in older populations. Establishing a gold standard for measuring frailty will improve identification of vulnerable, older patients, and subsequently direct designs for population-specific, multimodal prehabilitation to reduce postoperative morbidity and mortality.

Keywords: COVID-19; Disability; Long COVID; Pandemic; Postacute sequelae SARS CoV2; Prehabilitation; Rehabilitation; Surgery.

Publication types

Review

MeSH terms

Aged
COVID-19* / epidemiology
Ethnicity
Frail Elderly
Frailty*
Humans
Minority Groups
Pandemics
Preoperative Exercise