Grant: Project Grant

Over half a million Canadians have major surgery (like joint replacements, heart or cancer surgery) yearly. Surgery stresses people's bodies, much like running a marathon. Unlike runners, who train for their race, most Canadians are not actively preparing for surgery. This means that they may not be in the best possible shape for surgery and may suffer from complications, long hospital stay, or even die. Effective strategies to better prepare people for major surgery are needed. Prehabilitation means preparing for surgery through exercise, nutrition and/or stress management. People are very interested in prehabilitation because it makes sense that preparing people's minds and bodies for surgery will lead to better outcomes. Unfortunately, research has not always shown these benefits; we think this is because different types of patients need different types of prehabilitation. If we can understand what patient characteristics and what types of prehabilitation programs work best, we can use healthcare resources wisely, use patients' time wisely, and make sure the right patient receives the right care before surgery. We can also direct new research efforts toward the most promising programs and under-served patients. When research studies have conflicting findings, systematic reviews are important to sort out the reasons why. These studies summarize what is currently known in an area. Many systematic reviews of prehabilitation exist, but each focuses on a different aspect of prehabilitation or subsection of patients. Therefore, we will do a systematic review o systematic reviews to bring all existing prehabilitation evidence together. This type of overview will let us describe in detail what is known to work or not work in prehabilitation programs, as well as to identify the type of patients who may benefit most. Our review will be used to inform policy around how we prepare people for the stress of surgery and identify key areas of research that must be addressed.