Prähabilitation als OP-Vorbereitung bei Patienten mit Frailty

Ältere Menschen, die sich operieren lassen müssen, sind besonders gefährdet, von diesem Eingriff nicht zu profitieren. Komplikationen während und nach der Operation, längere Liegezeiten und eine damit einhergehende eingeschränkte Rehabilitationsfähigkeit führen zu einem Verlust an Selbstständigkeit und Lebensqualität. Eine Prähabilitation vor der Operation kann diesem Verlauf entgegenwirken.

Abstract

Older people demonstrate a higher risk for the occurrence of peri- and postsurgical complications. A frequent risk factor for this is the prevalence of a status called “frailty”. In general, this status can be reversed by adequate therapeutic and medical interventions. More, current evidence suggests that these measures, as part of a so-called prehabilitation, can reduce the risk for experiencing peri- and postsurgical complications and thus assist the rehabilitation process, increase quality of life, and avoid care dependency and a loss of autonomy of these patients. In this article, we describe the concept of prehabilitation, its options to adapt and design this new form of intervention, as well as presenting current evidence. An actual project and a case example on prehabilitation provide an example and outlook.

Kernaussagen

• Gebrechlichkeit (Frailty) ist ein komplexes Syndrom, charakterisiert durch die Verminderung physiologischer Reserven.

• Die Prävalenz der Gebrechlichkeit bei älteren Menschen liegt bei bis zu 43%.

• Mit einer Gebrechlichkeit gehen ein erhöhtes Risiko für peri- und postoperative Komplikationen einher und damit die Gefahr, dass die betroffenen Patienten von der Operation nicht profitieren.

• Eine Gebrechlichkeit ist kein fixer Zustand und kann durch geeignete Maßnahmen positiv beeinflusst werden.

• Eine Prähabilitation stellt eine präoperative Maßnahme zur Reduktion von peri- und postoperativen Komplikationen bei Risikogruppen dar.

• Eine Prähabilitation sollte multiprofessionell und multimodal organisiert sein.

• Weitere Forschung zur Evidenz der Effektivität einer Prähabilitation bei gebrechlichen älteren Menschen ist notwendig. In Deutschland erfolgt eine Evaluierung aktuell im Rahmen des Versorgungsforschungs-Projekts PRÄP-GO.

Schlüsselwörter

Prähabilitation - Frailty - Gebrechlichkeit - Versorgungsforschung

Keywords

prehabilitation - frailty - elderly - public health

Publication History

Article published online:
02 February 2023

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