Priority 18 from the Heart Surgery PSP

UNCERTAINTY: What can patients do (in terms of their lifestyle choices - exercise, diet, smoking, well-being etc.) before and after heart surgery to improve outcomes? (JLA PSP Priority 18)
Overall ranking 18
JLA question ID 0088/18
Explanatory note Cardiac rehabilitation is an extensively investigated topic in cardiac surgery research. On the other hand, despite general advices concerning prevention of cardiovascular diseases can be widely found in guidelines and systematic reviews, specific evidence in favour of prehabilitation are gaining increasing strength in the past years.
However, which interventions may benefit which kind of patient certainly needs further research. ~ Will exercise before surgery improve outcomes? What exercises or sports should the patients engage in or avoid? Does improving nutritional status before surgery have an impact on outcomes of cardiac surgery? 

Katsura M, Kuriyama A, Takeshima T, Fukuhara S, Furukawa TA. Preoperative inspiratory muscle training for postoperative pulmonary complications in adults undergoing cardiac and major abdominal surgery. Cochrane Database of Systematic Reviews. 2015(10); Ziehm S, Rosendahl J, Barth J, Strauss BM, Mehnert A, Koranyi S. Psychological interventions for acute pain after open heart surgery. Cochrane Database of Systematic Reviews. 2017(7); Egholm JWM, Pedersen B, Møller AM, Adami J, Juhl CB, Tønnesen H. Perioperative alcohol cessation intervention for postoperative complications. Cochrane Database of Systematic Reviews. 2018(11). 

Health Research Classification System category Cardiovascular
Extra information provided by this PSP
Original uncertainty examples Is there anything patients can do to prior to heart surgery to help their survival rate? ~ Before a heart operation what lifestyle has to be adopted? ~ Will exercise before surgery improve outcomes? ~ Does improving nutritional status positively impact functional outcomes? 
Submitted by  15 x patient, 9 x carers, 19 x healthcare professional, 5 x others
PSP information
PSP unique ID 0088
PSP name Heart Surgery
Total number of uncertainties identified by this PSP. 45  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 11 July 2019