Page 149 - Risk quantification and modification in older patients with colorectal cancer
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Prehabilitation in a multidisciplinary care program
aged 75 and up as our cohort, but left some room for personalised prehabilitation and rehabilitation fitting the clinical setting of daily practice. Thus making our program applicable, usable and reproducible.
An important question that remains is whether complications and mortality are the most relevant outcome parameters. Maybe for elderly patients self-sustainability, mobility and overall quality of life should be paramount.39 Future studies should put more focus on these topics and should also overcome the lack of consensus to what elements to include in a prehabilitation program33 and the problem of low adherence to the training protocol which was earlier reported to range from 16- 97%.9
Conclusion
We hypothesised that a comprehensive multidisciplinary care program would be beneficial for elderly patients by boosting perioperative resilience, preventing decline and thereby getting them back to their preoperative level of functioning as soon as possible.
In this study, we were not able to demonstrate a clear effect on perioperative complications and 1-year mortality after the implementation of our program. However, the use of two control cohorts allowed for a better insight into what drives improvement here. The fact that a significant improvement in outcome already occurred during the development of the program seems to imply that focused and dedicated multidisciplinary care is the essential element of favourable outcomes of CRC surgery in elderly patients and there lies the benefit of starting such a program.
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