Verbesserung des prä-und postoperativen Behandlungskonzepts. Große elektiv-chirurgische Eingriffe

Translated title of the contribution: Improving pre- and perioperative hospital care. Major elective surgery

Ilona M. Punt*, Roel van der Most, Bart C. Bongers, Anouk Didden, Erik H. J. Hulzebos, Jaap J. Dronkers, Nico L. U. van Meeteren

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Surgery is aimed at improving a patient's health. However, surgery is plagued with a risk of negative consequences, such as perioperative complications and prolonged hospitalization. Also, achieving preoperative levels of physical functionality may be delayed. Above all, the "waiting" period before the operation and the period of hospitalisation endanger the state of health, especially in frail patients.

The Better in Better out (TM) (BiBo (TM)) strategy is aimed at reducing the risk of a complicated postoperative course through the optimisation and professionalisation of perioperative treatment strategies in a physiotherapy activating context. BiBo (TM) includes four steps towards optimising personalised health care in patients scheduled for elective surgery: 1) preoperative risk assessment, 2) preoperative patient education, 3) preoperative exercise therapy for high-risk patients (prehabilitation) and 4) postoperative mobilisation and functional exercise therapy.

Preoperative screening is aimed at identifying frail, high-risk patients at an early stage, and advising these high-risk patients to participate in outpatient exercise training (prehabilitation) as soon as possible. By improving preoperative physical fitness, a patient is able to better withstand the impact of major surgery and this will lead to both a reduced risk of negative side effects and better short-term outcomes as a result. Besides prehabilitation, treatment culture and infrastructure should be inherently changing in such a way that patients stay as active as they can, socially, mentally and physically after discharge.

Translated title of the contributionImproving pre- and perioperative hospital care. Major elective surgery
Original languageGerman
Pages (from-to)410-418
Number of pages9
JournalBundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz
Volume60
Issue number4
DOIs
Publication statusPublished - Apr 2017

Keywords

  • High-risk patients
  • Physical fitness
  • Risk stratification
  • Prehabilitation
  • Elective surgery
  • TOTAL HIP-ARTHROPLASTY
  • OLDER-ADULTS
  • FUNCTIONAL MOBILITY
  • ABDOMINAL-SURGERY
  • KNEE ARTHROPLASTY
  • ELDERLY-PATIENTS
  • CONTROLLED-TRIAL
  • 6-MINUTE WALK
  • EXERCISE
  • COMPLICATIONS

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