RT Journal Article
SR Electronic
T1 Predictive modelling for optimization of preoperative care in multimorbid patients undergoing major surgery
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2936
DO 10.1183/13993003.congress-2020.2936
VO 56
IS suppl 64
A1 Anael Barberan-Garcia
A1 Mar Montane-Muntane
A1 Alicia Hervas
A1 Pilar Hurtado
A1 Betina Campero
A1 Bárbara Romano-Andrioni
A1 Silvia Teres-Belles
A1 Elena Gimeno-Santos
A1 Josep Roca
A1 Graciela Martinez-Palli
YR 2020
UL http://erj.ersjournals.com/content/56/suppl_64/2936.abstract
AB Introduction: Preoperative optimization programs are effective interventions to improve postoperative outcomes in patients undergoing major surgery. However, customization of these programs to multimorbid patients’ is an unmet need. The current study aims to identify factors associated to program completion, and to postoperative complications, in multimorbid patients undergoing major surgery.Methods: Inclusion criteria: 1) Undergoing to major surgery; 2) high-risk for surgical complications defined by age≥ 70 and/or American Society of Anesthesiologists risk scale 3-4. The program included 6 interventions: 1) Cardiorespiratory training; 2) Promotion of physical activity; 3) Volumetric inspirometer teaching; 4) Cognitive behavioural therapy; 5) Nutritional optimization; 6) Mindfulness. Program completion was defined as attending ≥80% of appointments.Results: From 200 patients, 120 (60%) completed the program. Among completers, 62 did not suffer from postoperative complications (52%). Undergoing oncologic surgery (24.5[3.9-153.8];p=0.001), suffering from endocrine and metabolic diseases (3.8[1.2-12.3];p=0.025) and willingness to participate in mindfulness sessions (3.1[1.03-9.15];p=0.044) were associated with program completion, while being older (0.93[0.88-0.97];p=0.002) was related to lower probability of completion. Among completers, higher baseline fitness (Duke Activity Status Index) (0.95[0.91-0.999];p=0.019) and higher risk of malnutrition (Malnutrition Universal Screening Tool) (1.8[1.1-3.1];p=0.023) were related to postoperative morbidity.Conclusions: The current study identifies actionable factors useful to personalize these programs which may facilitate its effectiveness.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 2936.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).