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Current Anesthesiology Reports
Published in: Current Anesthesiology Reports 1/2022

01-03-2022 | Care | Prehabilitation (B Riedel and S Jack, Section Editors)

Physical and Psychological Health Behavior Changes During the COVID-19 Pandemic that May Inform Surgical Prehabilitation: a Narrative Review

Authors: Julie K. Silver, Daniel Santa Mina, Andrew Bates, Chelsia Gillis, Emily M. Silver, Tracey L. Hunter, Sandy Jack

Published in: Current Anesthesiology Reports | Issue 1/2022

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Abstract

Purpose of Review

Multimodal prehabilitation aims to improve preoperative health in ways that reduce surgical complications and expedite post-operative recovery. However, the extent to which preoperative health has been affected by the COVID-19 pandemic is unclear and evidence for the mitigating effects of prehabilitation in this context has not been elucidated. The COVID-19 pandemic has forced a rapid reorganization of perioperative pathways. Delayed diagnosis and surgery have caused a backlog of cases awaiting surgery increasing the risk of more complex procedures due to disease progression. Poor fitness and preoperative deconditioning are predictive of surgical complications and may be compounded by pandemic-related restrictions to accessing supportive services. The COVID-19 pandemic has forced a rapid reorganization of perioperative pathways. This narrative review aims to summarize the understanding of the effects of the COVID-19 pandemic on preoperative health and related behaviors and their implication for the need and delivery for prehabilitation to engender improved surgical outcomes. A literature search of Medline was conducted for articles related to preoperative health, prehabilitation, and surgical outcomes published between December 1, 2020 and January 31, 2021. Additional hand searches for relevant publications within the included literature were also conducted through October 15, 2021.

Recent Findings

The COVID-19 pandemic, and measures designed to reduce the spread of the virus, have resulted in physical deconditioning, deleterious dietary changes, substance misuse, and heightened anxiety prior to surgery. Due to the adverse health changes prior to surgery, and often protracted waiting time for surgery, there is likely an elevated risk of peri- and post-operative complications. A small number of prehabilitation services and research programmes have been rapidly adapted or implemented to address these needs.

Summary

During the COVID-19 pandemic to date, people undergoing surgery have faced a triple threat posed by extended wait times for surgery, reduced access to supportive services, and an elevated risk of poor outcomes. It is imperative that healthcare providers find ways to employ evidence-based prehabilitation strategies that are accessible and safe to mitigate the negative impact of the pandemic on surgical outcomes. Attention should be paid to cohorts most affected by established health inequities and further exacerbated by the pandemic.
Appendix
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Metadata
Title
Physical and Psychological Health Behavior Changes During the COVID-19 Pandemic that May Inform Surgical Prehabilitation: a Narrative Review
Authors
Julie K. Silver
Daniel Santa Mina
Andrew Bates
Chelsia Gillis
Emily M. Silver
Tracey L. Hunter
Sandy Jack
Publication date
01-03-2022
Publisher
Springer US
Keywords
Care
COVID-19
Published in
Current Anesthesiology Reports / Issue 1/2022
Electronic ISSN: 2167-6275
DOI
https://doi.org/10.1007/s40140-022-00520-6

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PREHABILITATION (B RIEDEL and S JACK, SECTION EDITORS)

Postoperative Delirium Prevention and Novel Cognitive Therapy Interventions

PREHABILITATION (B RIEDEL AND S JACK, SECTION EDITORS)

Hematinic and Iron Optimization in Peri-operative Anemia and Iron Deficiency