Approximately 70% of thoracic surgery patients are pre-frail or frail, characterized by
reduced strength, endurance, and physiologic function. Frailty is associated with poor
perioperative outcomes, including increased complications, length of stay, post-discharge
institutionalization, healthcare costs, and mortality. As a result, surgical and
geriatric clinical societies now recommend including a frailty assessment in older adult
pre-operative surgical evaluations. To mitigate the risks associated with frailty,
prehabilitation (prehab) has been included as a component of the American College of
Surgeons "Strong for Surgery" quality initiative. Evidence-based practices to optimize
preoperative health have been shown to improve physical conditioning and return to
autonomy, as well as, reduce length of stay, postoperative complications, and healthcare
costs. Older patients who need surgery view prehab favorably, particularly if it is
home-based, recommended by a medical professional, and free. The primary objective will
be to conduct a feasibility evaluation using the Reach, Effectiveness, Adoption,
Implementation, and Maintenance (RE-AIM) framework. The secondary objectives will be to
measure functional status and clinical outcomes longitudinally in patients undergoing
prehab.
Participants will receive the prehab program from 2-12 weeks prior to undergoing elective
inpatient thoracic surgery. Participants will complete surveys at 2-3 weeks, 2 months,
3-4 months, and 6 months after surgery.
