The effectiveness of multimodal prehabilitation in high-risk patients for cardiac complications

Introduction. Currently, surgical treatment is the main type of therapy for malignant lung neoplasms. This pathology is most commonly found in elderly patients with significant comorbid conditions. These conditions create a risk of cardiovascular complications after surgery, which worsens the postoperative period.

Materials and methods. The article presents an analysis of postoperative indicators in patients from the high-risk group for cardiovascular complications after undergoing lobectomy for malignant lung neoplasms. The subjects were divided into two groups: patients who underwent multimodal prehabilitation (n=39) and the control group (n=36). Before randomization, an assessment of external respiratory function, left ventricular ejection fraction, mean pulmonary artery pressure, and functional test results was performed. The risk assessment for developing cardiovascular complications was conducted according to the proposed risk model.

Results. An analysis of postoperative complications (Grade II–Grade V) showed a lower number of complications in the group of patients who underwent prehabilitation (p=0,020). The frequency of cardiovascular complications in the prehabilitation group was significantly lower than in the control group (p=0,040). The length of hospitalization differed significantly depending on the presence of prehabilitation: in the control group, it was 12,08±2,26 days, while in the prehabilitation group it was 11,05±1,81 days (p=0,031).

Conclusions. The use of a prehabilitation program in high-risk patients may help reduce the risk of developing cardiac complications after surgical treatment of lung cancer.

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