Prehabilitation for patients undergoing metabolic/bariatric surgery: a retrospective cohort study using propensity score matching.
Prehabilitation showed no difference in total weight loss 12 months after bariatric surgery.
Prehabilitation for patients undergoing metabolic/bariatric surgery: a retrospective cohort study using propensity score matching.
IMPORTANCE: Multimodal prehabilitation improves outcomes in colorectal surgery, but its effectiveness and cost-effectiveness before metabolic and bariatric surgery are unknown.
To evaluate the effectiveness and cost-effectiveness of a 6-week multimodal prehabilitation programme compared with standard preintervention education in patients undergoing bariatric surgery.
DESIGN, SETTING, AND PARTICIPANTS: Propensity score matched cohort observational study at Shanghai Tenth People's Hospital, China, January 2022 to January 2025.
similar total weight loss with or without prehabilitation
At 3 months, prehabilitation showed significantly greater weight loss (adjusted β = 2.85 kg; 95% CI, 1.77 to 3.93; p < 0.001), lower body fat, lower diastolic blood pressure, and higher Short Form-36 (SF-36) mental scores.
All differences were attenuated by 6 months.
No serious adverse events occurred.
Total costs were modestly higher in the prehabilitation group (mean, ¥84 843 vs ¥78 051), a difference attributable almost entirely to the prehabilitation programme itself; because the incremental effect on weight loss at 12 months was not statistically significant, a meaningful incremental cost-effectiveness ratio could not be estimated.
A 6-week multimodal prehabilitation programme accelerated early postoperative weight loss and improved short-term functional outcomes but did not improve total weight loss at 12 months.
Because prehabilitation added cost without a demonstrable difference in 12-month weight loss, a cost-effectiveness advantage could not be established.
The dominant metabolic effects of bariatric surgery appear to override the incremental gains of preoperative conditioning over time.