Long-Term Outcomes of Multimodal Prehabilitation with High Protein Oral and HMB Supplementation in Sarcopenic Surgical Patients: The HEROS Study.

Chair rise repetitions improved significantly at six months post-operatively compared to baseline.

• Median chair rise repetitions increased from 11 to 15 (p < 0.001)
• 36 patients were included with a median age of 71.5 years (IQR: 55–90)
• 50% were male
• Paired Wilcoxon signed-rank tests were used to evaluate outcomes between time points

Six-minute walk test distance improved significantly at six months post-operatively compared to baseline.

• Median six-minute walk test distance increased from 349 m to 387 m (p = 0.020)
• Measurement was taken from pre-operative baseline to six months post-operatively
• This functional outcome was assessed as part of a multimodal prehabilitation protocol

Mid-arm muscle circumference increased significantly at six months post-operatively compared to baseline.

• Median mid-arm muscle circumference increased from 22.5 cm to 23.7 cm (p = 0.013)
• This anthropometric measure reflects changes in muscle mass
• Assessed in a cohort of sarcopenic and severely sarcopenic patients undergoing gastrointestinal surgery

Mid-arm muscle area increased significantly at six months post-operatively compared to baseline.

• Median mid-arm muscle area increased from 39.3 cm² to 44.8 cm² (p = 0.005)
• This was one of several anthropometric measures that significantly improved
• Patients were followed up from two to four weeks pre-operatively to six months post-operatively

Body weight and BMI increased significantly at six months post-operatively compared to baseline.

• Median weight increased from 50.8 kg to 51.6 kg (p = 0.023)
• Median BMI increased from 21.8 kg/m² to 23.2 kg/m² (p = 0.025)
• These improvements were observed in a population where 33.3% were sarcopenic and 66.7% were severely sarcopenic

No significant difference in intramuscular adipose tissue percentage (IMAT%) was observed at six months post-operatively.

• IMAT% showed no statistically significant change at the six-month post-operative time point
• This was in contrast to functional and anthropometric outcomes which did show significant improvements
• 36 patients were included in the analysis

The study cohort consisted predominantly of severely sarcopenic patients undergoing gastrointestinal surgery.

• 36 patients were included with a median age of 71.5 years (IQR: 55–90)
• 12 (33.3%) patients were sarcopenic, while 24 (66.7%) were severely sarcopenic
• Patients were between 40 and 90 years old and enrolled from June 2022 to January 2024
• The study was a prospective single-centre pilot cohort study