Postoperative outcomes following prehabilitation vs no prehabilitation in elective colorectal surgery: A 2:1 propensity score-matched analysis

doi:10.4240/wjgs.v17.i11.108345

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastrointest Surg. Nov 27, 2025; 17(11): 108345
Published online Nov 27, 2025. doi: 10.4240/wjgs.v17.i11.108345

Table 1 Clinical demographics of patients who underwent elective major colorectal surgery in those with and without prehabilitation

	Overall group, n = 208					PSM group, n = 144
	Total	Prehabilitation (n = 148)	No prehabilitation (n = 60)	P value	SMD	Total	Prehabilitation (n = 96)	No prehabilitation (n = 48)	P value	SMD
Age, years¹	79.0 (76.0-82.0)	79.0 (76.0-82.0)	79.0 (75.3-81.0)	0.371	0.167	78.0 (75.0-82.0)	78.0 (75.0-82.0)	79.0 (76.0-82.0)	0.603	0.076
Age ≥ 80 years	91 (43.8)	66 (44.6)	25 (41.7)	0.700	N/A	57 (39.6)	36 (37.5)	21 (43.8)	0.470	N/A
Sex, male¹	103 (49.5)	70 (47.3)	33 (55.0)	0.314	0.154	73 (50.7)	49 (51.0)	24 (50.0)	0.906	0.021
ASA score	3.0 (2.0-3.0)	3.0 (2.0-3.0)	3.0 (2.0-3.0)	0.091	N/A	3.0 (2.0-3.0)	3.0 (2.0-3.0)	3.0 (2.0-3.0)	0.410	N/A
≥ 3¹	131 (63.0)	98 (66.2)	33 (55.0)	0.129	0.230	80 (55.6)	55 (57.3)	25 (52.1)	0.553	0.104
CCI	4.0 (2.3-6.0)	4.0 (3.0-6.0)	3.0 (2.0-5.0)	0.004^a	N/A	3.0 (2.0-6.0)	3.0 (2.0-6.0)	3.0 (2.0-5.0)	0.153	N/A
≥ 4¹	116 (55.8)	89 (60.1)	27 (45.0)	0.046^a	0.305	68 (47.2)	46 (47.9)	22 (45.8)	0.813	0.042
Predicted mortality					N/A					N/A
P-POSSUM, %	6.9 (4.0-10.6)	6.8 (4.2-10.7)	7.0 (3.7-10.5)	0.465	N/A	6.2 (3.4-10.3)	6.2 (3.4-10.1)	7.0 (3.5-10.8)	0.879	N/A
P-POSSUM > 5%¹	140 (67.3)	102 (68.9)	38 (63.3)	0.437	N/A	93 (64.6)	62 (64.6)	31 (64.6)	1.000	N/A
Predicted morbidity, %	41.8 (30.4-53.0)	42.6 (31.0-54.5)	39.8 (29.3-51.0)	0.199	N/A	39.0 (29.3-50.9)	38.3 (28.9-50.9)	39.8 (29.3-51.0)	0.909	N/A
Modified Barthel index¹	100 (98-100)	100 (98-100)	100 (100-100)	0.009^a	0.174	100 (100-100)	100 (100-100)	100 (100-100)	0.572	0.019
Premorbid status				0.014^a	N/A				0.354	N/A
Community ambulant	183 (88.0)	125 (84.5)	58 (96.7)		N/A	134 (93.1)	88 (91.7)	46 (95.8)		N/A
Home bound	25 (12.0)	23 (15.5)	2 (3.3)		N/A	10 (6.9)	8 (8.3)	2 (4.2)		N/A
Bed bound	0	0	0		N/A	0	0	0		N/A
Frail, yes¹	66 (31.7)	57 (38.5)	9 (15.0)	< 0.001^a	0.548	25 (17.4)	17 (17.7)	8 (16.7)	0.876	0.027
Tumor stage				0.618	N/A				0.365	N/A
0	18 (8.7)	14 (9.5)	4 (6.7)		N/A	12 (8.3)	10 (10.4)	2 (4.2)		N/A
1	25 (12.0)	18 (12.2)	7 (11.7)		N/A	19 (13.2)	12 (12.5)	7 (14.6)		N/A
2	77 (37.0)	51 (34.5)	26 (43.3)		N/A	51 (35.4)	30 (31.3)	21 (43.8)		N/A
3	85 (40.9)	62 (41.9)	23 (38.3)		N/A	60 (41.7)	42 (43.8)	18 (37.5)		N/A
4	3 (1.4)	3 (2.0)	0 (0)		N/A	2 (1.4)	2 (2.1)	0 (0)		N/A
Tumor stage ≥ 3, yes	88 (42.3)	65 (43.9)	23 (38.3)	0.460	N/A	62 (43.1)	44 (45.8)	18 (37.5)	0.341	N/A
Tumor site				0.377	N/A				0.743	N/A
Colon	177 (85.1)	128 (86.5)	49 (81.7)		N/A	122 (84.7)	82 (85.4)	40 (83.3)		N/A
Rectum	31 (14.9)	20 (13.5)	11 (18.3)		N/A	22 (15.3)	14 (14.6)	8 (16.7)		N/A
Surgical access¹				0.076	0.271				0.479	0.125
Open	117 (56.3)	89 (60.1)	28 (46.7)		N/A	75 (52.1)	48 (50.0)	21 (43.8)		N/A
Laparoscopic	91 (43.8)	59 (39.9)	32 (53.3)		N/A	59 (47.9)	48 (50.0)	21 (43.8)		N/A

¹Propensity score matching was performed for these variables due to potential and/or significant effects on clinical outcomes or due to significant differences in demographics between the two study groups.

^aP < 0.05.

Data are presented as median (interquartile range) or n (%). ASA: American Society of Anesthesiologists; CCI: Charlson comorbidity index; P-POSSUM: Portsmouth-Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity; SMD: Standardized mean difference; N/A: Not applicable; PSM: Propensity score matching.

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Citation: Chan KS, Ng P, Tan L, Soh REJ, Tan BT, Ong YJ, Chong JL, Mantoo SK, Lee YZ, Tan KY, Lee DJK. Postoperative outcomes following prehabilitation vs no prehabilitation in elective colorectal surgery: A 2:1 propensity score-matched analysis. World J Gastrointest Surg 2025; 17(11): 108345
URL: https://www.wjgnet.com/1948-9366/full/v17/i11/108345.htm
DOI: https://dx.doi.org/10.4240/wjgs.v17.i11.108345

Chan KS, Ng P, Tan L, Soh REJ, Tan BT, Ong YJ, Chong JL, Mantoo SK, Lee YZ, Tan KY, Lee DJK. Postoperative outcomes following prehabilitation vs no prehabilitation in elective colorectal surgery: A 2:1 propensity score-matched analysis. World J Gastrointest Surg 2025; 17(11): 108345 [PMID: 41357626 DOI: 10.4240/wjgs.v17.i11.108345]

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