The PREHAAAB Trial: Multimodal prehabilitation for patients awaiting open abdominal aortic aneurysm repair – A study protocol for an international randomized controlled trial
Bibliographic record
Abstract
BACKGROUND: Patients undergoing open abdominal aortic aneurysm (AAA) repair remain at high risk for postoperative complications, particularly when presenting with limited baseline functional capacity. Prehabilitation, encompassing physical, nutritional, and psychological optimization before surgery, may improve outcomes in this population. However, evidence is limited in the context of open AAA repair. OBJECTIVE: To evaluate the effectiveness of a multimodal prehabilitation program in reducing the incidence of postoperative complications in patients undergoing open AAA repair. METHODS: This is a multicenter, international, randomized controlled trial. Eligible participants include adults scheduled for elective open AAA surgery. A total of 152 participants will be randomized 1:1 to receive either standard preoperative care or a 6-week multimodal prehabilitation program consisting of supervised exercise training, individualized nutritional support, and psychological counseling. The primary outcome is the rate of postoperative complications as measured by the Comprehensive Complication Index (CCI). Secondary outcomes include length of hospital stay, and readmission rates, changes in functional capacity, health-related quality of life and anxiety & depression. Data will be analyzed on an intention-to-treat basis. The study complies with SPIRIT 2013 guidelines and is registered at ClinicalTrials.gov (NCT05756283). DISCUSSION: This trial will address a significant evidence gap regarding preoperative optimization in open abdominal aneurysm surgery. Findings will inform best practices for reducing morbidity in this high-risk population and contribute to enhanced recovery strategies in vascular surgery. TRIAL REGISTRATION: [NCT05756283].
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.021 | 0.019 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.007 | 0.004 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.006 | 0.006 |
| Insufficient payload (model declined to judge) | 0.041 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".