Frailty Risk Assessment and Improvement in Liver and pancreatic cancer surgery. (FRAIL)

The elective surgical population is expanding internationally as the global volume of major surgical procedures continues to increase year by year. Elder patients represent a challenge to the perioperative team, and accurate preoperative risk stratification is necessary to identify patients at a risk of a poor outcome who may benefit from preoperative intervention. Patient’s post-operative functional

impairment is multifactorial in origin. Risk factors for a poor outcome include both fixed factors (e.g., age and chronic co-morbidities) but also potentially modifiable risk factors (e.g., physical performance, nutritional status, anemia, intoxications). Nowadays prehabilitation is an upcoming subject and it seems

to be one of the best ways to improve postoperative outcome. The purpose of optimizing patients is to properly prepare patients for surgery. Prehabilitation might offer the solution to preoperatively optimize

patients’ performance status to withstand intensive treatments as surgery and as a consequence lower the number and severity perioperative complications. By reducing perioperative complications, we can reduce healthcare costs. Recent research examining hospital length of stay and readmission rates provides promising findings with respect to the value of prehabilitation in economic and sustainable healthcare models.

The aim of the project is therefore first to ‘optimize’ the prehabilitation

clinic and subsequently to implement the prehabilitation clinic into all surgical departments of the UMCG and next into other hospitals.

Results :

Recent research emphasises that prehabilitation may reduce postoperative complications after major abdominal surgery. Evidence that prehabilitation also has financial benefits may accelerate the implementation of prehabilitation programs in daily care. The online tool developed in this work estimated that the multimodal prehabilitation program for pancreatic surgery is financially beneficial. This online tool enables health care providers to calculate the potential financial benefits of the multimodal prehabilitation program for their specific populations, departments, or hospitals. The implementation of prehabilitation programs may therefore reduce health care costs, which is an important economic and societal impact.