Multi-Therapy Preoperative Preparation Program for Cardiothoracic and Major Surgery (MPMS)

Summary This article proposal outlines a multidisciplinary Multi‑therapy Preoperative Preparation Program for Major Surgery (MPMS) designed for vulnerable, high‑risk patients undergoing major elective procedures including cardiac and thoracic surgery. It aims to reduce postoperative complications, ICU and ward length of stay, infections, and healthcare costs, while improving recovery time, survival, quality of life and overall patient experience. MPMS is a structured, patient‑centred prehabilitation pathway that integrates anaesthesiology/intensive care review, comprehensive nutritional assessment and support, psychological optimisation (including anxiety, depression, smoking and alcohol interventions), and targeted physiotherapy‑based prehabilitation. It uses frailty and nutritional screening to select candidates, focuses on modifiable risk factors, and embeds robust outcome measurement (clinical events, length of stay, days at home, and patient‑reported outcomes) supported by a smartphone application, aligning with contemporary value‑based perioperative care models.