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Final Program


Final Congress Guide

Therapeutics

1000 Section - Long-term effect of exercise prehabilitation on recurrent hospitalisations and survival after cardiac surgery

Tuesday, May 19, 2026
6:00 PM - 7:30 PM PT
Objectives : Prehabilitation aims to enhance physiological and functional reserves, helping patients to better withstand surgical stress and improve early-to-medium-term outcomes after cardiac surgery. However, its effects on postoperative healthcare utilisation and long-term survival are rarely measured. This study investigates the long-term effects of exercise prehabilitation on recurrent hospitalisations and survival in frail patients undergoing cardiac surgery.

Design: This post-hoc analysis followed up all frail participants (Clinical Frailty Scale score of 4-6) from the PREhabilitation for improving QUality of recovery after ELective cardiac surgery (PREQUEL) trial until 31 December 2024. Participants in the prehabilitation group received individualised exercise training, supervised by a physiotherapist, twice weekly for a median duration of 5 weeks. Data on hospital readmissions and vital status for participants with surgery completed were retrieved retrospectively from electronic medical records. The effects of prehabilitation were analysed using multivariable modified Poisson regression with robust standard error variance, Poisson regression, negative binomial regression, and survival curve analysis.

Results: This study included 136 participants (prehabilitation: 58, usual care: 78) with 94 males (69.1%) and a median (IQR) age of 64 (59-69) years. Prehabilitation did not significantly reduce the risk of readmissions (Risk Ratio 0.91, 95% CI: 0.72–1.16) with 119 readmissions occurring in 35 prehabilitation participants (60.3%) compared to 165 readmissions in 52 usual care participants (66.7%). Prehabilitation showed a non-significant 13% reduction in readmission rate (Incidence Rate Ratio [IRR] 0.87, 95% CI: 0.69–1.11) and a non-significant 5% reduction in cumulative readmission hospital bed days (IRR 0.95, 95% CI: 0.59–1.55). Notably, prehabilitation improved long-term survival (restricted mean survival time difference at 4 years: 0.22 years, 95% CI: 0.01–0.44; P=0.044).

Conclusion:

While exercise-based prehabilitation did not significantly reduce the long-term risk, rate, or total duration of readmission stays, it demonstrated a modest improvement in long-term survival after cardiac surgery.