Canadian doctors are promoting the idea of “prehabilitation” for elderly heart disease patients awaiting heart surgery. “Prehab” offers the opportunity for people to prepare for surgery, mentally and physically, to improve the post-operation recovery process.
From the University of Manitoba in Canada, a group of scientists have been studying the implementation of prehab for elderly patients who are at a greater risk of poor post-op outcomes and quality of life despite a perfectly successful procedure. In Canada, patients are put on a two-month waiting list for heart surgery. This time could allow for prehab participation, which includes exercise training, education, and social support. Instead of waiting – sedentarily and anxiously – for surgery, patients could maximize their chances of positive post-op outcomes with prehab.
"The increasing number of older adults with a heart disease and subsequent increase in demand for heart procedures represents a veritable 'silver tsunami'," explained lead investigator Dr. Rakesh C. Arora, MD, PhD. "Many of these patients have low physiological reserve. So when they undergo cardiac surgery, they experience a disproportionate decline in their health condition resulting in a long recovery time.”
Researchers from a recent Monash University study discussed the “silver tsunami” phenomenon in the context of an aging immune system and cancer. They found that age-related inflammation, or “inflamm-aging,” is likely a huge factor in the increased incidence of cancer for older people.
In the context of cardiology, the “silver tsunami” concept essentially means that as the population gets older, more people require surgery for heart disease, the most common cause of death for both women and men worldwide. The more elderly patients there are undergoing heart surgery, the longer the hospital stays and the more dangerous the post-op complications. Prehab is designed to improve post-op conditions and ease the transition from the hospital to back home.
Canadian researchers have been reviewing existing research discussing the benefits of prehab, which has been implemented before in bowel and bone surgery but is still uncommon for heart surgery patients.
They found that new treatment protocols – Enhanced Recovery Problems (ERPs) – help clinicians choose the best prehab plan for elderly patients awaiting heart surgery. Most plans revolve around nutrition optimization, exercise training, and anxiety reduction.
“There is an urgent need for the heart care team to ensure that the patients are not only liberated of cardiac disease symptoms, but also experience a better postoperative health-related quality of life, so they don't just survive, but thrive after their procedure,” Arora concluded.
The present study was published in the journal Canadian Journal of Cardiology.