Prehabilitation in colorectal cancer surgery improves outcome and reduces hospital costs

Charissa R Sabajo; David W G Ten Cate; Margot H M Heijmans; Christian T G Koot; Lisanne V L van Leeuwen; Gerrit D Slooter

doi:10.1016/j.ejso.2023.107302

Prehabilitation in colorectal cancer surgery improves outcome and reduces hospital costs

Eur J Surg Oncol. 2024 Jan;50(1):107302. doi: 10.1016/j.ejso.2023.107302. Epub 2023 Nov 28.

Authors

Charissa R Sabajo¹, David W G Ten Cate², Margot H M Heijmans², Christian T G Koot³, Lisanne V L van Leeuwen⁴, Gerrit D Slooter⁵

Affiliations

¹ Department of Surgery, Máxima Medical Center, De Run 4600, 5504 DB, Veldhoven, the Netherlands; Department of Surgery, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.
² Department of Surgery, Máxima Medical Center, De Run 4600, 5504 DB, Veldhoven, the Netherlands.
³ Department of Finance and Control, Máxima Medical Center, De Run 4600, 5504 DB, Veldhoven, the Netherlands.
⁴ Scientific Center for Quality of Healthcare, Radboud University Medical Center, Kapittelweg 54, 6525 EP, Nijmegen, the Netherlands.
⁵ Department of Surgery, Máxima Medical Center, De Run 4600, 5504 DB, Veldhoven, the Netherlands. Electronic address: g.slooter@mmc.nl.

PMID: 38043359
DOI: 10.1016/j.ejso.2023.107302

Abstract

Introduction: Increasing evidence suggests that multimodal prehabilitation programs reduce postoperative complication rates and length of stay. Nevertheless, prehabilitation is not standard care yet, also as financial consequences of such programs are lacking. Aim of this study was to analyse clinical outcomes and effects on hospital resources if prehabilitation is implemented for patients who are planned for colorectal surgery.

Materials and methods: Patients undergoing elective colorectal surgery and who received either prehabilitation or standard care between January 2017 and March 2022 in a regional Dutch hospital were included. Outcome parameters were length of hospital stay, 30-day postoperative complications, 30-day ICU admission, readmission rates and hospital costs.

Results: A total of 196 patients completed prehabilitation whereas 390 patients received standard care. Lower overall complication rates (31 % vs 40 %, p = 0.04) and severe complication rates (20 % vs 31 %, p = 0.01) were observed in the prehabilitation group compared to standard care. Length of stay was shorter in the prehabilitation group (mean 5.80 days vs 6.71 days). In hospital cost savings were €1109 per patient, while the calculated investment for prehabilitation was €969.

Conclusion: Implementation of a multimodal prehabilitation program in colorectal surgery reduces postoperative complication rates, length of stay and hospital costs.

MeSH terms

Colorectal Neoplasms* / complications
Hospital Costs
Humans
Length of Stay
Postoperative Complications / epidemiology
Postoperative Complications / etiology
Postoperative Complications / prevention & control
Preoperative Care*
Preoperative Exercise