Prehabilitation may help mitigate an increase in COVID-19 peripandemic surgical morbidity and mortality
Open accessAbstract
As physicians specializing in rehabilitation medicine consider sequelae from the novel coronavirus pandemic that began in 2019, one issue that should be top of mind is the physiologic effect that large-scale social distancing had on the health of patients in general but, more specifically, on preoperative patients who had their surgeries delayed or will have newly scheduled procedures during the peripandemic period. Predictably, as the virus becomes less prevalent, there will be a tremendous motivation to move forward with scheduling operations from both patient care and institutional perspectives. However, one can anticipate a pandemic-related increase in surgical morbidity and mortality above prepandemic levels, particularly in older or medically frail patients even if they did not have a novel coronavirus (i.e., COVID-19) infection. Therefore, now is the time to consider for patients awaiting surgery a wider adoption of prehabilitation—physical and psychological assessments that establish a baseline functional level, identify impairments, and provide interventions that promote physical and psychological health to reduce the incidence and/or severity of future impairments.
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Essential procedures include those where a delay of two or three months significantly impacts outcomes, or where surgery is crucial for managing cancers such as breast, colon, gastric, pancreatic, liver, bladder, renal, lung, and brain tumors.
“Apart from emergency operations, any essential procedures may include those where a delay by two or three months can significantly impact on outcomes and/or those where surgery is a crucial component of cancer management, such as for breast, colon, gastric, pancreatic, liver, bladder, renal, lung and brain tumors [42,43].”
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- Authors
- Silver, J. K.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Silver, Julie K.
- ORCID
- Silver, Julie K.
- Venue
- American Journal of Physical Medicine & Rehabilitation
- Published
- 2020-04-22
- Volume
- 99
- Issue
- 6
- Pages
- 459-463
- ISSN
- 0894-9115 (ISSN-L)
- 1537-7385
- PMC
- PMC7253050
- OpenAlex
- W3020057095
- Cited by
- 36
- References
- 19
- Citations by year
- 2026: 3 · 2024: 2 · 2023: 3 · 2022: 9 · 2021: 8 · 2020: 11
- FWCI
- 7.08
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Physical Medicine & Rehabilitation (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Keywords
- prehabilitation, COVID-19 pandemic, surgical morbidity, postoperative mortality, delayed surgery, social distancing, frailty, elderly patients, preoperative assessment, physical and mental health, rehabilitation medicine
- MeSH terms
- COVID-19, Humans, Pneumonia, Viral, Postoperative Complications, Preoperative Care, Coronavirus Infections, Risk Assessment, Pandemics
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