{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T22:11:13Z","timestamp":1793311873990,"version":"4.5.0"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patients with valvular heart disease are at high risk of postoperative pulmonary complications, which contribute to morbidity and mortality. However, few studies have focused specifically on peri\u2010operative rehabilitation in this patient population. We aimed to evaluate whether peri\u2010operative rehabilitation benefits patients undergoing elective cardiac valve surgery by reducing the incidence of postoperative pulmonary complications, the duration of postoperative hospitalisation and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single\u2010centre, randomised controlled trial compared usual care (usual care group) with a peri\u2010operative rehabilitation bundle (rehabilitation group) comprising four components: education; inspiratory muscle training; active cycle of breathing techniques; and early mobilisation. The primary outcome was a composite measure of the occurrence of postoperative pulmonary complications within the first 7\u2009days; incidence of prolonged postoperative hospitalisation &gt;\u20097\u2009days; and in\u2010hospital all\u2010cause mortality. Secondary outcomes included each component of primary outcome measure; duration of stay in the ICU; total duration of postoperative hospitalisation; and 3\u2010month all\u2010cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>On an intention\u2010to\u2010treat basis, data from 818 patients were analysed (419 allocated to the usual care group and 399 to the rehabilitation group). The primary composite outcome did not differ between groups, occurring in 224\/419 (53.5%) patients allocated to the usual care group and 206\/399 (51.6%) patients allocated to the rehabilitation group (odds ratio 0.88, 95%CI 0.66\u20131.17, p\u2009=\u20090.376). Postoperative pulmonary complications were present in 197 (47.1%) patients allocated to the usual care group and 161 (40.4%) patients allocated to the rehabilitation group (odds ratio 0.720, 95%CI 0.541\u20130.956, p\u2009=\u20090.023). There was no significant difference between the groups in terms of duration of postoperative hospital stay of &gt;\u20097\u2009days or in\u2010hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Peri\u2010operative rehabilitation reduced the incidence of postoperative pulmonary complications in patients having surgery for valvular heart disease. We recommend incorporating comprehensive peri\u2010operative rehabilitation into the clinical management of these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.70025","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T08:32:33Z","timestamp":1761035553000},"page":"362-372","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Peri\u2010operative rehabilitation in patients undergoing elective cardiac valve surgery: a randomised controlled trial"],"prefix":"10.1111","volume":"81","author":[{"given":"Yuting","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Cardiology Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University  Guangzhou Guangdong 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