How important is it to screen patients and measure their fitness prior to surgery? What is exercise training in the preoperative period?

There is a very clear relationship between physical fitness and mortality. Importantly, when we think of prehabilitation, or exercise training, it's good to remember that you get the greatest benefit in the most unfit patients, in terms of mortality reductions. The "pandemic ... of physical inactivity worldwide" is believed to cause more than 5 million deaths annually. The advantage of fitness in terms of predicting perioperative outcomes is it is an important modifiable risk factor before major surgery; we can modify health behaviors and exercise and we can sometimes optimize comorbidities before surgery. Exercise is real medicine!

Originally part of the hugely successful EBPOM Live from London 2020 conference this piece is nicely complimented by the panel discussion which TopMedTalk has also released free of charge here: https://www.topmedtalk.com/ebpom-london-2020-prehabilitation-update/

Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton.