Long-term outcomes of major abdominal surgery and postoperative delirium after multimodal prehabilitation of older patie
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ORIGINAL ARTICLE
Long‑term outcomes of major abdominal surgery and postoperative delirium after multimodal prehabilitation of older patients Ties L. Janssen1 · Ewout W. Steyerberg2 · Chantal C. H. A. van Hoof‑de Lepper1 · Tom C. J. Seerden3 · Dominique C. de Lange4 · Jan H. Wijsman1 · Gwan H. Ho1 · Paul D. Gobardhan1 · Lijckle van der Laan1,5 Received: 27 February 2020 / Accepted: 9 May 2020 © Springer Nature Singapore Pte Ltd. 2020
Abstract Purpose The long-term outcomes of surgery followed by delirium after multimodal prehabilitation program are largely unknown. We conducted this study to assess the effects of prehabilitation on 1-year mortality and of postoperative delirium on 1-year mortality and functional outcomes. Methods The subjects of this study were patients aged ≥ 70 years who underwent elective surgery for abdominal aortic aneurysm (AAA) or colorectal cancer (CRC) between January 2013, and June 2018. A prehabilitation program was implemented in November 2015, which aimed to optimize physical health, nutritional status, factors of frailty and preoperative anemia prior to surgery. The outcomes were assessed as mortality after 6 and 12 months, compared between the two treatment groups; and mortality and functional outcomes, compared between patients with and those without delirium. Results There were 627 patients (controls N = 360, prehabilitation N = 267) included in this study. Prehabilitation did not reduce mortality after 1 year (HR 1.31 [95% CI 0.75–2.30]; p = 0.34). Delirium was significantly associated with 1-year mortality (HR 4.36 [95% CI 2.45–7.75]; p
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