Prehabilitatie binnen de vaatchirurgie

The aging population presents several challenges in vascular surgery. As people age, they often develop one or multiple chronic conditions, such as an aneurysm of the abdominal aorta (AAA) and chronic limb-threatening ischemia (CLTI). These conditions frequently require a surgical intervention to improve quality of life (QoL) and survival. However, postoperative complications are significant concerns, especially in elderly patients. A common and serious postoperative complication is delirium, which is associated with cognitive and functional decline, decreased QoL, prolonged length of hospital stay (LoS), and increased mortality. Delirium is difficult to treat, highlighting the importance of prevention. Prehabilitation is a proactive intervention that focuses on enhancing patients' overall fitness prior to surgery. Its aim is to mitigate the impact of surgical stress, enhance recovery, and reduce the likelihood of postoperative complications, including delirium. Multimodal prehabilitation programs typically include physical, nutritional and cognitive support, along with interventions such as a comprehensive geriatric assessment, smoking cessation and anaemia treatment. This thesis explores the potential of multimodal prehabilitation to improve outcomes in older patients undergoing vascular surgery for AAA or CLTI. Through a systematic review and clinical studies, this thesis shows that prehabilitation is safe, well-received by patients, and associated with shorter hospital stays and fewer minor complications. While findings on delirium prevention were promising, larger studies are needed to confirm its impact.