P1047 - MULTIDISCIPLINARY PREHABILITATION IMPROVES NUTRITION AND FUNCTION: EXPERIENCE FROM A HONG KONG PILOT

P1047

MULTIDISCIPLINARY PREHABILITATION IMPROVES NUTRITION AND FUNCTION: EXPERIENCE FROM A HONG KONG PILOT

E. Y.-F. Cheung^1,*, Y. L. Or², T. S. M. Yip¹, Y. F. Cheung¹, G. P. S. Lui³, R. T. K. Cheung⁴

¹Department of Surgery, ²Department of Anaesthesiology and Operating Services, ³Dietetics Department, ⁴Physiotherapy Department, North District Hospital, Hong Kong, Hong Kong SAR

Rationale: Prehabilitation improves surgical outcomes by enhancing physiological reserve and function.Experience in Hong Kong is limited and a pilot was performed to evaluate its effectiveness.

Methods: From Sep to Nov 2024,patients who received colectomies were screened.High risk patients(>=2 in surgical/medical/nutritional/functional risks) were recruited.Patients were assessed in a multidisciplinary clinic 4-8 weeks before surgery.Individual plans were made after case discussion.Prehabilitation included nutrition intervention, exercise programme, nurse counselling and medical optimisation.Patients were reevaluated in the week before surgery and on discharge.

Results: 39 patients were screened and 10 were recruited.5 patients were male and median age was 76(range 68-81).All patients were planned for laparoscopic colectomies for tumours.Median severe complication risk by NSQIP was 8.15%(6.3-16.4).3 patients were ASA 3 and 4 respectively.3 and 1 patients had SGA B and C.Median DASI predicted VO2max was 23.8L/min(12.7-34.6) and median 6 minutes walking test(6MWT) distance was 325m(180-408).Median DASS21 score for depression,anxiety and stress was 1, 0.5 and 1.5 respectively.Good compliance to prehabilitation was observed.On evaluation, median change in fat-free and muscle mass by BIA were +1.3 and +1.2%. Significant functional improvement was seen in 6MWT(+29m), hand grip strength(right +1.0; left +2.3kg) and 30 seconds sit-to-stand test(+1.5times).Psychological status was static.All patients proceeded to surgery.There was no unplanned ICU stay,and median hospital stay was 10.5 days.4 patients experienced complications including atrial fibrillation,leak and prolonged ileus.All patients return to usual level of care on discharge.Median satisfaction was 8/10. 

Conclusion: Prehabilitation improves nutrition and function,and maintains psychological status.Further evaluation by larger studies is warranted.

Disclosure of Interest: None declared