Impact of a multimodal prehabilitation program on the cardiovascular risk profile of high-risk oncologic and non-oncologic patients undergoing major colorectal surgery

Multimodal prehabilitation (MPrehab) optimizes patient fitness before surgery. Preoperative NT-pro-BNP concentrations predict cardiovascular risk and are recommended by ESC guidelines. Exercise is known to improve functional capacity, reduce NT-pro-BNP, and enhance cardiovascular outcomes.

Assess the impact of MPrehab on preoperative NT-pro-BNP concentrations.

Data from patients scheduled for elective major colorectal surgery were evaluated pre- and post-MPrehab. High-risk patients underwent a personalized MPrehab program comprising aerobic/resistance exercise, nutritional, psychological, and medical optimization. Paired t-tests or Wilcoxon signed-rank tests were used as appropriate.

Forty-six high-risk patients were treated with MPrehab (median duration: 44 days, IQR 29–84). Functional capacity improved significantly (6-min walk distance: 428.3±136.4 m to 472±142.4 m, +44 m, p=0.0028), and NT-pro-BNP levels decreased (median 244 pg/ml, IQR 88–889.5 vs 180 pg/ml, IQR 65–143, p=0.025).

MPrehab significantly increased functional capacity and reduced NT-pro-BNP levels in high-risk surgical patients. Further studies are needed to confirm its impact on postoperative cardiovascular outcomesFigure 1  Table 1