Are you fit for surgery?

Are you healthy enough to have surgery?

More hospitals are asking that question before patients undergo elective procedures such as hip and knee replacements. They are identifying those at higher risk of infections and other complications due to diabetes, heart disease and anemia—or simply being sedentary and out of shape. And they are steering them to “pre-habilitation” programs that include medical treatments, diets and exercise regimens to improve their chances of a successful surgery.

At the University of Michigan Health System, a program known as MSHOP, for Michigan Surgical and Health Optimization Program, assesses patients’ risk for surgical complications based on their CT-scans, personal characteristics and a surgical outcomes database. It then assigns a regimen they can complete at home for a week to a month before surgery, to improve fitness, nutrition, and breathing capacity, with inexpensive aids like DVDs and text message reminders.

“The reason many patients don’t do well is because they are already deconditioned as couch potatoes, and then they get a big operation which makes them even more frail,” says IHPI member Michael Englesbe, a University of Michigan transplant surgeon and associate professor who led the study and directs the MSHOP program. Dr. Englesbe says that the program “empowers patients to have control over their outcome,” and recommends all patients train for elective surgery, much as they would before athletic competition.