Personalized community-based prehabilitation for a high-risk surgical patient opting for pylorus-preserving pancreaticoduodenectomy: a case report

Figures & data

Figure 1. The patient journey listed on a timeline view ordered by start of the event

Abbreviations: CT = computed tomography; HPB = hepatopancreatobiliary.

Figure 2. The step of the hypothesis-oriented-algorithm for clinicians II expanded with the international classification of functioning framework

Abbreviations: ADL = activities of daily life; COPD = chronic obstructive pulmonary disease; PPPD = pylorus-preserving pancreaticoduodenectomy; THP = total hip replacement.

Table 1. Results of the medical, nutritional, and geriatric assessment

Anesthesiologist
General
ASA classification	III
Mallampati	1
TMA	Normal
Physical fitness level (MET)	4
Cardiac evaluation
Electrocardiagram	Sinus rhythm, LAD, LVH
Echocardiogram	LVEF 45–50%
Pulmonary evaluation
Spirometry	FEV1/FVC 69%; FEV1 76%; DLCO 55% of predicted
Blood tests
Hemoglobin (mmol/L)	6.2
Clinical nurse specialist
Short nutritional assessment procedure
Body height (m)	1.71
Body mass (kg)	85.0
Figure	Large
BMI (kg/m^2)	29.07
Body mass loss (kg)	+ 5.00
Arm circumference (cm)	34.00
Triceps skinfold (mm)	43.00
Muscle area upper arm (cm^2)	33.41
Fat area upper arm (cm^2)	58.58
Handgrip strength (kg)	27
Cognitive screening
G-8	12

Abbreviations: ASA = American Society of Anesthesiologists; DLCO = diffusing capacity of carbon monoxide; FEV₁ = forced expiratory volume in 1 s; FVC = forced vital capacity; G-8 = Geriatric 8; LAD = left axis deviation; LVEF = left ventricular ejection fraction; LVH = left ventricular hypertrophy; MET = metabolic equivalent of task; TMA = thyroid-mandible angle.

Figure 3. Results of the performance-based tests during the pre- and postoperative period

Abbreviations: DASI = Duke activity status index; FTSTS = five times sit-to-stand; HGS = handgrip strength; TUG = timed up-and-go; VSAQ = veterans-specific activity questionnaire; 2MWT = two-minute walk test.