AIRR - ANZCA Institutional Research Repository
Skip navigation
Please use this identifier to cite or link to this item: http://hdl.handle.net/11055/1130
Title: Preoperative assessment and prehabilitation in patients with obesity undergoing non-bariatric surgery: a systematic review
Authors: Martin, G
Marginson, B
ANZCA/FPM Author: Smith, NA
Keywords: Preoperative assessment
Prehabilitation
Obesity
Anaesthesia
Non-bariatric surgery
Issue Date: Jun-2022
Citation: 78:110676
Abstract: Study objective: The optimal methods of preoperative assessment and prehabilitation specific to patients with obesity undergoing non-bariatric surgery have not been described. We investigated two questions: 1) which methods of preoperative assessment in patients with obesity are associated with improved patient management, and 2) which methods of prehabilitation in patients with obesity are associated with improved patient outcomes? Design: Systematic review. Setting: Preoperative assessment and optimisation, and postoperative outcomes. Patients: Patients with obesity scheduled for surgery of any type. Interventions: We searched six electronic databases for clinical studies addressing either preoperative assessment or preoperative optimisation. Measurements: The primary outcome measure for the assessment review was any impact on preoperative disease diagnosis or progression, or postoperative complications. The primary outcome measure for the prehabilitation review was any postoperative change in disease or health status, or any medical or surgical complications. Main results: Twenty one papers were included in the assessment review (total of 5090 participants) and twenty five for prehabilitation (30,170 participants). Approximately two thirds of papers reported on bariatric surgery populations. In the assessment review, studies reported on either the preoperative detection of comorbidities or the prediction of postoperative complications. The only assessment tool with any suggestion of benefit was polysomnography. A range of methods of prehabilitation were found for question 2. Forty eight percent of papers reported improvement in some or all study outcomes. The most successful intervention was exercise, with 4 of 5 exercise-based trials showing improvement in either some or all postoperative outcomes. Conclusions: There is a limited body of work addressing preoperative assessment and prehabilitation specific to surgical patients with obesity, especially when undergoing non-bariatric surgery. Preoperative polysomnography was shown to improve both the diagnosis of obstructive sleep apnoea and the prediction of postoperative complications. Half of the prehabilitation studies showed evidence of benefit. From this review, we were unable to make strong recommendations as to best practice in patients with obesity presenting for non-bariatric surgery.
URI: http://hdl.handle.net/11055/1130
DOI: 10.1016/j.jclinane.2022.110676
ORCID: 0000-0002-8337-4352
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/35152081/
ISSN: 0952-8180
Journal Title: Journal of Clinical Anaesthesia
Type: Journal Article
Affiliates: Wollongong Hospital
University of Wollongong
Study/Trial: Systematic Reviews
Appears in Collections:Scholarly and Clinical

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.