ArticlePloS one2019
Multimodal prehabilitation to reduce the incidence of delirium and other adverse events in elderly patients undergoing elective major abdominal surgery: An uncontrolled before-and-after study.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 7 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
41 citing papers in PubMed, 7 syntheses or guidelines pooled it, 95 citations in OpenAlex.
- Rationales for Prehabilitation Programs in Patients Preparing for Oncologic Surgery: A Systematic Review.Annals of surgical oncology · 2026Pooled it
- Pooled it
- Perioperative neurocognitive disorder in colorectal cancer surgery: a systematic review of incidence, mechanisms, and interventions.Frontiers in surgery · 2025Pooled it
- EAES/SAGES evidence-based recommendations and expert consensus on optimization of perioperative care in older adults.Surgical endoscopy · 2024Guideline
- Cost-effectiveness of prehabilitation prior to elective surgery: a systematic review of economic evaluations.BMC medicine · 2023Pooled it
- Effects and duration of exercise-based prehabilitation in surgical therapy of colon and rectal cancer: a systematic review and meta-analysis.Journal of cancer research and clinical oncology · 2022Pooled it
- Prevalence and risk factors for postoperative delirium in patients with colorectal carcinoma: a systematic review and meta-analysis.International journal of colorectal disease · 2020Pooled it
- Facilitators and barriers to participation in prehabilitation prior to orthopaedic elective surgery - a qualitative study with elderly (pre-)frail patients.BMC geriatrics · 2025Trial
- Trial
- Feasibility, acceptability, and preliminary estimates of a multimodal AKTIVER Heart Delirium Prevention Program in patients indicated for cardiac surgery: study protocol of a randomized controlled PREVENT POstoperative Delirium (PREVENT-POD) Pilot Study.Pilot and feasibility studies · 2026Article
- Prehabilitation Prior to Colorectal Cancer Surgery: Impact and Implementation.Journal of surgical oncology · 2026Article
- Impact of CGA and Surgical Risk Calculator before elective cancer surgery on postoperative delirium in elderly patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Observational
- Comparative Efficacy of Different Prehabilitation Strategies in Colorectal Surgery Patients: A Network Meta-Analysis.Archives of rehabilitation research and clinical translation · 2025Review
- Evaluating the predictive accuracy of cognitive screeners BAMCOG and MoCA in identifying postoperative delirium risk in aortic valve replacement patients: A cohort study.PLOS digital health · 2025Article
- Advances in research on the pathogenesis and signaling pathways associated with postoperative delirium (Review).Molecular medicine reports · 2025Review
- The benefits of a department-wide prehabilitation program: A propensity score match analysis.Surgery · 2025Article
- Navigating the Surgical Pathway for Frail, Older Adults Undergoing Colorectal Surgery.Clinics in colon and rectal surgery · 2025Review
- Bridging nutrition and neurology: malnutrition's role in perioperative neurocognitive disorders.Frontiers in nutrition · 2025Review
- Assessing the Risk of Postoperative Delirium Through Comprehensive Geriatric Assessment and Eastern Cooperative Oncology Group Performance Status of Elderly Patients With Gastric Cancer.Annals of surgical oncology · 2024Article
- Development and validation of a nomogram to predict postoperative delirium in older patients after major abdominal surgery: a retrospective case-control study.Perioperative medicine (London, England) · 2024Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelirium is a common and serious complication in elderly patients undergoing major abdominal surgery, with significant adverse outcomes. Successful strategies or therapies to reduce the incidence of delirium are scarce. The objective of this study was to assess the role of prehabilitation in reducing the incidence of delirium in elderly patients.
methodsA single-center uncontrolled before-and-after study was conducted, including patients aged 70 years or older who underwent elective abdominal surgery for colorectal carcinoma or an abdominal aortic aneurysm between January 2013 and October 2015 (control group) and between November 2015 and June 2018 (prehabilitation group). The prehabilitation group received interventions to improve patients' physical health, nutritional status, factors of frailty and preoperative anaemia prior to surgery. The primary outcome was incidence of delirium, diagnosed with the DSM-V criteria or the confusion assessment method. Secondary outcomes were additional complications, length of stay, unplanned ICU admission, length of ICU stay, readmission rate, institutionalization, and in-hospital or 30-day mortality.
resultA total of 360 control patients and 267 prehabilitation patients were included in the final analysis. The mean number of prehabilitation days was 39 days. The prehabilitation group had a higher burden of comorbidities and was more physically and visually impaired at baseline. At adjusted logistic regression analysis, delirium incidence was reduced significantly from 11.7 to 8.2% (OR 0.56; 95% CI 0.32-0.98; P = 0.043). No statistically significant effects were seen on secondary outcomes.
conclusionCurrent prehabilitation program is feasible and safe, and can reduce delirium incidence in elderly patients undergoing elective major abdominal surgery. This program merits further evaluation.
trial registrationDutch Trial Registration, NTR5932.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.