Effect of Prehabilitation on Postoperative Recovery of Frail Elderly Undergoing Coronary Artery Bypass Graft Surgery

Abstract

Background: Prehabilitation, a multimodal preoperative intervention including exercise training, nutritional optimization, and psychological support, has emerged as a strategy to enhance physiological reserve and improve surgical outcomes.

Aim: This study aimed to evaluate the effect of prehabilitation program on recovery of frail elderly postoperative CABG surgery.

Methods: A quasi-experimental study was conducted at cardiothoracic inpatient, cardiothoracic ICU at Sudeanie hospital in Zagzig University & cardiothoracic outpatient clinic  in Zagzig University hospital. A purposive sample of 80 elderly patients (≥60 years) scheduled for elective on-pump CABG surgery was recruited and randomly assigned into two groups: an intervention group (n = 40) and a control group (n = 40). Data were collected using a structured interviewing questionnaire, the Clinical Frailty Scale (CFS), and the 15-item Quality of Recovery (QoR-15) scale.

Results: The findings revealed a statistically significant improvement in postoperative recovery among patients in the intervention group compared to the control group. The study group demonstrated significantly higher mean scores across all domains of the QoR-15 on postoperative day three (p < 0.01). Multivariate regression analysis identified participation in the prehabilitation program as an independent positive predictor of improved quality of recovery.

Conclusion: The structured prehabilitation program significantly enhanced postoperative recovery and functional outcomes among frail elderly patients undergoing CABG surgery.

Recommendations:  Prehabilitation programs incorporating physical exercise, nutritional counseling, and psychological support should be routinely implemented for elderly patients scheduled for CABG surgery to enhance postoperative recovery and reduce morbidity.