Evidence map›Paper›PMID 38968183›Full record

ArticlePloS one2024

Multimodal prehabilitation (Fit4Surgery) in high-impact surgery to enhance surgical outcomes: Study protocol of F4S PREHAB, a single center stepped wedge trial.

Dieuwke Strijker, Luuk Drager, Monique van Asseldonk, Femke Atsma, Manon van den Berg, Elke van Daal, Linda van Heusden-Scholtalbers, Jeroen Meijerink, Petra Servaes, Steven Teerenstra and 3 more

Abstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Nutritional prehabilitation strategies in abdominal surgery.Current opinion in clinical nutrition and metabolic care · 2026
    Review
  4. Article
  5. Article
  6. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Dieuwke StrijkerDepartment of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
Luuk DragerDepartment of Operating Rooms, Radboud University Medical Center, Nijmegen, the Netherlands.ORCID 0000-0003-3283-095X
Monique van AsseldonkDepartment of Gastroenterology and Hepatology, Dietetics and Intestinal Failure, Radboud University Medical Center, Nijmegen, the Netherlands.
Femke AtsmaDepartment of Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands.
Manon van den BergDepartment of Gastroenterology and Hepatology, Dietetics and Intestinal Failure, Radboud University Medical Center, Nijmegen, the Netherlands.
Elke van DaalDepartment of Operating Rooms, Radboud University Medical Center, Nijmegen, the Netherlands.
Linda van Heusden-ScholtalbersDepartment of Rehabilitation, Radboud University Medical Center, Nijmegen, the Netherlands.
Jeroen MeijerinkDepartment of Operating Rooms, Radboud University Medical Center, Nijmegen, the Netherlands.
Petra ServaesDepartment of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands.
Steven TeerenstraDepartment of Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands.
Sjors VerlaanDepartment of Operating Rooms, Radboud University Medical Center, Nijmegen, the Netherlands.
Baukje van den HeuvelDepartment of Operating Rooms, Radboud University Medical Center, Nijmegen, the Netherlands.
Kees van LaarhovenDepartment of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh-impact surgery imposes a significant physiological and functional burden and is associated with substantial postoperative morbidity. Multimodal prehabilitation has demonstrated a reduction in postoperative complications and enhanced functional recovery, mainly in abdominal cancer surgery. Common preoperative risk factors shared among patients undergoing high-impact surgery, extending beyond abdominal cancer surgery procedures, suggest the relevance of multimodal prehabilitation to a broader patient population. This stepped wedge trial primarily aims to examine the hospital-wide effect of multimodal prehabilitation, compared to standard preoperative care, on the occurrence and severity of postoperative complications. Secondary and tertiary endpoints include length of hospital stay, physical fitness, nutritional status, mental health, intoxications, and cost-effectiveness of the intervention.

methodsThe Fit4Surgery (F4S) PREHAB trial is a monocenter stepped wedge trial in an academic hospital. Adult patients, divided into 20 health clusters based on specific diagnoses, will be assessed for eligibility and receive usual preoperative care or multimodal prehabilitation. Patient enrollment commenced in March 2021 and continues up to and including April 2024. The intervention consists of a high-intensity exercise program, a nutritional intervention, psychological support, and smoking and alcohol cessation. The primary outcome will be measured by the Clavien-Dindo classification (grade II or higher) and the Comprehensive Complication Index (CCI). DISCUSSION: Multimodal prehabilitation potentially reduces postoperative complications and enhances functional recovery. This is the first study to determine the hospital-wide effect and cost-effectiveness of multimodal prehabilitation in patients across various surgical specialties.

Indexed as

Postoperative ComplicationsPreoperative ExerciseAdultCost-Benefit AnalysisFemaleHumansLength of StayMalePreoperative CareTreatment Outcome

Identifiers

PMID38968183
PMCPMC11226070

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Registered trials

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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.