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Abdominal Aortic AneurysmNCT05756283

The PREHAAAB Trial: Multimodal Prehabilitation for Patients Awaiting Open Abdominal Aortic Aneurysm Repair

A study testing Multimodal Prehabilitation in people with Abdominal Aortic Aneurysm, run by McGill University Health Centre/Research Institute of the McGill University Health Centre at 1 site in Canada.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

An abdominal aortic aneurysm is a condition where the major artery in the abdomen becomes larger than usual. Over time, as it continues to grow, the wall of the artery weakens and there is a risk that the artery can burst causing internal bleeding and death. Read more about this study

Who is it for?
Ages 50 years and older
Conditions the study is for
Abdominal Aortic Aneurysm
What is being tested?
Multimodal Prehabilitation
Could I receive a placebo?
No, everyone receives an active treatment
How many people
152 participants
Where
1 siteCanada
Study dates
Sep 2023to Sep 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 50 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Participants older than 50 years of age awaiting elective open AAA repair with AAA diameter ≤6.9cm. Participants should have the ability to give informed consent.

Who cannot join

  • Participants undergoing thoracic, thoracoabdominal and/or perivisceral AAA repair.
  • Participants with ruptured or symptomatic AAA.
  • Participants with AAA maximal diameter ≥7cm.
  • Physical inability to exercise: severe osteoarthritis, musculoskeletal or neurological impairment that precludes exercise.
  • Contraindication to exercise: rest systolic blood pressure ≥ 180 mmHg and/or diastolic ≥ 100 mmHg, uncontrolled atrial or ventricular arrythmias or proven exercise induced arrhythmias, unstable angina, unstable or acute heart failure, severe symptomatic valvular stenosis, dynamic left ventricular outflow tract obstruction or other comorbidities that imply clinical instability.
  • Cognitive impairment that would impede understanding of study procedures, informed consent or study questionnaires or the inability to effectively communicate in English/French/Spanish/Catalan.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Marie-Amelie Lucaszewski, PhD contact

+1 514.934.1934 ext. 35113

Canada1 site
  • MUHC-RIMUHC Royal Victoria Hospital

    Montreal, Quebec, H4A 3J1

Other trials in Canada

About this study

Official title: The PREHAAAB Trial: Multimodal Prehabilitation for Patients Awaiting Open Abdominal Aortic Aneurysm Repair - An International Randomized Controlled Trial

An abdominal aortic aneurysm is a condition where the major artery in the abdomen becomes larger than usual. Over time, as it continues to grow, the wall of the artery weakens and there is a risk that the artery can burst causing internal bleeding and death. Aortic aneurysms are fixed when they reach a certain size to prevent that outcome. The surgery to fix them is a major, high-risk surgery that is associated with a lot of complications and a slow recovery back to normal. The time between diagnosis and surgery is called the pre-operative period and is a key time to optimize a patient's health in order to ensure the best possible outcomes following surgery. This study will look at whether a multidisciplinary pre-operative program that involves exercise training, nutritional advice and supplementation, and psychosocial support will reduce complications following surgery. This program should decrease complications and speed up a patient's recovery back to normal after surgery. It is also a way for patients to take ownership of their disease and play an active role in their health care journey. The benefits from this program will go beyond the pre-operative time frame, as the habits and knowledge gained will improve their health over their lifetime. This study will also assess the economic impact and cost of a program like this.

Read the detailed description

Abdominal aortic aneurysms (AAA) are asymptomatic until they rupture, which carries an 80- 90% mortality. Therefore, AAA are surgically repaired when they reach 5.0 cm in women and 5.5cm in men. Despite advances to surgical technique and peri-operative care, open surgical repair still carries a high incidence of post-operative complications of 30-40%, and a long recovery period. This is largely because the surgery itself is major abdominal surgery, and these patients often have significant comorbidities and low functional status. Multimodal prehabilitation (MP) is a concept that uses the preoperative timeframe (between diagnosis and surgery) to optimize physical, nutritional, and emotional wellbeing to improve a patient's functional status and ability to withstand the stress of surgery. To date, there is no study evaluating the effect of MP on post-operative complications following open AAA repair.

The primary objective of this trial is to determine if MP will decrease complications as measured by the comprehensive complication index following open AAA repair compared to standard of care. This trial will also assess the effect of MP on functional capacity, hospital length of stay, 30-day mortality and health related quality of life, as well as to assess cost effectiveness, adherence, and fidelity to the intervention.

Being tested
Multimodal Prehabilitation
Keywords
Prehabilitation, Exercise, Nutrition, Quality of life, Postoperative Complications, Psychosocial intervention
Medical subject headings
Aortic Aneurysm, Abdominal, Motor Activity, Postoperative Complications

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Multimodal PrehabilitationBehavioural

    EXERCISE

    • Supervised exercise
    • High intensity interval training
    • Strength exercise
    • Home-based exercise / promotion of physical activity
    • Low-moderate intensity aerobic training
    • Inspiratory muscle training
    • Low-moderate intensity strength training

    NUTRITION: nutrition education and optimization. Intake of 0.4g/kg of whey isolate after every supervised training.

    PSYCHOSOCIAL: mindfulness, cognitive reframing and coping strategies.

Study groups in NCT05756283
Study groupRoleWhat they receive
Multimodal PrehabilitationExperimentalParticipants in the intervention group will undergo, in addition to the standard of care, 6+/-1 weeks of a personalized multimodal prehabilitation program. The interventions included will be patient-centered, aiming to optimize patients' preoperative health status while enhancing their empowerment and engagement.
Receives: Behavioral: Multimodal Prehabilitation
Control group (standard of care)No interventionParticipants in the control group will receive the standard of care. This will include comorbidity optimization, anemia correction and smoking cessation advice if deemed appropriate.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Postoperative complications measured by the Comprehensive Complication Index (CCI)

    The CCI was developed to address some of the limitations of traditional surgical morbidity reporting, such as only reporting the most severe complication or only picking the most common types of complications. It is scored on a true linear interval scale from 0-100 and incorporates the totality of all complications and their severity experienced by a patient

    Measured: CCI will be measured from admission to 6 weeks postoperatively

Secondary outcomes (27)
  1. ICU Length of stay

    Intensive Care Unit length of stay

    Measured: From admission to 6 weeks postoperatively

  2. Hospital length of stay

    Days from admission to discharge from the hospital

    Measured: From admission to 6 weeks postoperatively

  3. Reinterventions

    Need for surgical reintervention due to surgical complications

    Measured: from surgery day to 6 week postoperatively

  4. Readmission

    Readmission to the hospital

    Measured: at 6 weeks and at 1 year postoperatively

  5. Emergency Room visits

    Visits to the emergency room with or without admission to the hospital

    Measured: at 6 weeks and at 1 year postoperatively

  6. 6-Minute Walk Test

    6-minute walk test

    Measured: Measured at baseline, preoperatively and 6 weeks postoperatively

  7. VO2 peak

    Oxygen consumption at peak exercise

    Measured: Measured at baseline and preoperatively

  8. VO2 AT

    Oxygen consumption at anaerobic Threshold

    Measured: Measured at baseline and preoperatively

  9. VE/VCO2

    Minute ventilation/carbon dioxide production

    Measured: Measured at baseline and preoperatively

  10. Yale physical activity survey (YPAS)

    Questionnaire of daily physical activity

    Measured: Measured at baseline, preoperatively, 6 weeks and 1 year postoperatively

  11. SF36

    Quality of life questionnaire

    Measured: Measured at baseline, preoperatively, 6 weeks and 1 year postoperatively

  12. Depression

    Depression measured by the Hospital Anxiety and Depression questionnaire (HADS) 0 (no depression)- 21 (maximal depression)

    Measured: Measured at baseline, preoperatively, 6 weeks and 1 year postoperatively

  13. Anxiety

    Anxiety measured by the Hospital Anxiety and Depression questionnaire (HADS) 0 (no anxiety)- 21 (maximal anxiety)

    Measured: Measured at baseline, preoperatively, 6 weeks and 1 year postoperatively

  14. Patient Generated Subjective Global Assessment (PG-SGA)

    Malnutrition assessment tool

    Measured: Measured at baseline, preoperatively

  15. Compliance to intervention

    Compliance to the different components of the intervention, measured by attendance to supervised sessions (%), adherence to nutritional counseling and supplementation (%), adherence to home-based exercise (%) and adherence to the psychosocial sessions (%)

    Measured: Measured from baseline to preoperatively

  16. Fidelity to exercise intervention

    Real training wattage and kg vs expected

    Measured: Measured from baseline to preoperatively

  17. Height

    measurement of height in meters

    Measured: Measured at baseline and preoperatively

  18. Weight

    measurement of Weight in kg

    Measured: Measured at baseline and preoperatively

  19. Body Mass Index (BMI)

    Measurement of body mass index (weight and height will be combined to report BMI in kg/m^2)

    Measured: Measured at baseline and preoperatively

  20. Body Fat percentage

    Measurement of body fat percentage using Bioelectrical Impedance Analysis

    Measured: Measured at baseline and preoperatively

  21. Fat Free Mass (FFM)

    Measurement of body fa free mass in kg, using Bioelectrical Impedance Analysis

    Measured: Measured at baseline and preoperatively

  22. Muscle Mass

    Measurement of muscle mass in kg, using Bioelectrical Impedance Analysis

    Measured: Measured at baseline and preoperatively

  23. Phase angle

    Measurement of phase angle, using Bioelectrical Impedance Analysis

    Measured: Measured at baseline and preoperatively

  24. Satisfaction and acceptability

    Intervention satisfaction and acceptability questionnaire

    Measured: Preoperative assessment

  25. Incidents of adverse events (prehabilitation safety and tolerability)

    Incidence of adverse events and severe adverse events during prehabilitation program

    Measured: Measured from Baseline to Preoperatively

  26. Quality adjusted life years

    Quality adjusted life years derived from SF36 data (SF6D)

    Measured: Measured at baseline, preoperatively, 6 weeks and 1 year postoperatively

  27. Prehabilitation cost-effectiveness

    Measurement of prehabilitation cost-effectiveness using data from SF6D, prehabilitation costs and hospitalization related costs.

    Measured: Measured at 1 year postoperatively

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Mar 2023
  2. Study startSep 2023 (estimated)
  3. Primary completionSep 2026 (estimated)
  4. Study completionSep 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
152 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05756283
Sponsor's protocol ID
PREHAAAB Trial
Status last verified
Feb 2023
First submitted
14 Feb 2023
Last updated
6 Mar 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Barberan-Garcia A, Ubre M, Roca J, Lacy AM, Burgos F, Risco R, Momblan D, Balust J, Blanco I, Martinez-Palli G. Personalised Prehabilitation in High-risk Patients Undergoing Elective Major Abdominal Surgery: A Randomized Blinded Controlled Trial. Ann Surg. 2018 Jan;267(1):50-56. doi: 10.1097/SLA.0000000000002293.

    PubMed 28489682
  • Barakat HM, Shahin Y, Khan JA, McCollum PT, Chetter IC. Preoperative Supervised Exercise Improves Outcomes After Elective Abdominal Aortic Aneurysm Repair: A Randomized Controlled Trial. Ann Surg. 2016 Jul;264(1):47-53. doi: 10.1097/SLA.0000000000001609.

    PubMed 26756766
  • Tew GA, Batterham AM, Colling K, Gray J, Kerr K, Kothmann E, Nawaz S, Weston M, Yates D, Danjoux G. Randomized feasibility trial of high-intensity interval training before elective abdominal aortic aneurysm repair. Br J Surg. 2017 Dec;104(13):1791-1801. doi: 10.1002/bjs.10669. Epub 2017 Oct 9.

    PubMed 28990651
  • Fenton C, Tan AR, Abaraogu UO, McCaslin JE. Prehabilitation exercise therapy before elective abdominal aortic aneurysm repair. Cochrane Database Syst Rev. 2021 Jul 8;7(7):CD013662. doi: 10.1002/14651858.CD013662.pub2.

    PubMed 34236703
  • Staiger RD, Cimino M, Javed A, Biondo S, Fondevila C, Perinel J, Aragao AC, Torzilli G, Wolfgang C, Adham M, Pinto-Marques H, Dutkowski P, Puhan MA, Clavien PA. The Comprehensive Complication Index (CCI(R)) is a Novel Cost Assessment Tool for Surgical Procedures. Ann Surg. 2018 Nov;268(5):784-791. doi: 10.1097/SLA.0000000000002902.

    PubMed 30272585
  • Coca-Martinez M, Doonan RJ, Gillis C, Mackenzie K, Obrand DI, Bayne JP, Steinmetz OK, Girsowicz E, Lopez-Baamonde M, Jessula S, Yugueros X, Martinez-Palli G, Gill HL. The PREHAAAB Trial: Multimodal prehabilitation for patients awaiting open abdominal aortic aneurysm repair - A study protocol for an international randomized controlled trial. PLoS One. 2025 Dec 29;20(12):e0339473. doi: 10.1371/journal.pone.0339473. eCollection 2025.

    PubMed 41460856

Questions about this trial

What is this clinical trial studying?

A study testing Multimodal Prehabilitation in people with Abdominal Aortic Aneurysm, run by McGill University Health Centre/Research Institute of the McGill University Health Centre at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 6 Mar 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Heather Gill, MD (+1 514.934.1934 ext. 35113, heather.gill@mail.mcgill.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Postoperative complications measured by the Comprehensive Complication Index (CCI) (time frame: CCI will be measured from admission to 6 weeks postoperatively). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05756283, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Mar 2023.

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