{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:59:54Z","timestamp":1792717194109,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prehabilitation, including preoperative exercise, nutrition optimization, behavioral support, and smoking cessation services, may improve physiological reserve in patients undergoing surgery; however, large administrative and claims\u2010based real\u2010world evaluations across diverse procedure types have remained limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study used IBM MarketScan claims (2010\u20132020) to identify adults undergoing coronary artery bypass grafting (CABG), abdominal aortic aneurysm (AAA) repair, pneumonectomy, pancreatectomy, and colectomy. Prehabilitation was defined as claims for physical therapy, nutrition counseling, psychological\/behavioral counseling, and smoking cessation services within 30\u201390\u00a0days preoperatively. Multivariable logistic regression assessed outcomes, including any major postoperative complication, readmission, and costs, adjusting for baseline patient and hospital factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 136,674 patients, 6.6% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a09077) received prehabilitation. The median age was 56 (49\u201360), and 42.0% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a057,035) were female. Patients who received prehabilitation more commonly underwent pneumonectomy (15.8% vs. 11.3%) or AAA repair (4.7% vs. 3.2%) and received care at urban\/metropolitan hospitals (86.9% vs. 84.7%) compared with individuals who did not undergo prehabilitation (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Prehabilitation was associated with lower odds of any index complication (aOR 0.94, 95% CI 0.90\u20130.99) and lower risk of myocardial infarction (MI) at index hospitalization (aOR 0.78, 95% CI 0.71\u20130.85), 30\u00a0days (aOR 0.79, 95% CI 0.72\u20130.86), and 90\u00a0days (aOR 0.81, 95% CI 0.74\u20130.89). Moreover, patients who received prehabilitation experienced higher costs, both preoperatively (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      4227, 95% CI 3834\u20134621) and postoperatively (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      4020, 95% CI 2866\u20135173). In sub\u2010analyses, the association between prehabilitation and lower odds of MI was maintained among CABG patients (aOR 0.83, 95% CI 0.76\u20130.90).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prehabilitation was associated with lower postoperative cardiac events but higher perioperative costs; the most favorable associations were observed among CABG patients, although these subgroup findings should be interpreted cautiously.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70437","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T05:18:02Z","timestamp":1781068682000},"page":"1835-1845","source":"Crossref","is-referenced-by-count":1,"title":["Prehabilitation and Postoperative Outcomes in Major Surgery: A Retrospective Cohort Study Using MarketScan Claims 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