- ICH GCP
- Registro de ensaios clínicos dos EUA
- Ensaio Clínico NCT07677319
SAGE-Heart : Senior Assessment fraGility and Post-opErative QALYs 1 Year After Emergency HEART Surgery for Patients Aged 75 and Older (SAGE-Heart)
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
The advancement of structural cardiology, particularly with percutaneous valve interventions, offers new treatment options without the need for cardiopulmonary bypass (CPB). Despite an increase in the use of these techniques, some studies highlight a notable rise in CPB usage in patients aged 80 and over, from 13.8% in 2013 to 20.5% in 2022. In France, the population aged 85 and above is expected to triple by 2050, meaning more elderly patients will be eligible for CPB cardiac surgery. Several global studies have examined the outcomes of older individuals undergoing CPB cardiac surgery. While EuroSCORE II and STS scores are effective in predicting short-term mortality, they lack accuracy in predicting long-term mortality, particularly in frail patients, and do not assess quality of life. New tools to evaluate frailty, such as the Clinical Frailty Scale (CFS), are now used in preoperative assessments for planned cardiac interventions. Identifying frail elderly patients early is crucial for improving patient and family information on care plans, especially in high-risk surgeries. Even in emergencies, patients must remain involved in their health decisions, and multidisciplinary collaboration is vital for improving postoperative recovery and quality of life.
Data will be collected :
- Preoperative: During the anesthesia consultation: Calculation of the CFS (frailty assessment = CFS ≥ 4) EuroQoL 5D-5L (quality of life, with the index calculated with the French value set of the EuroQol), and routine care (renal function: urea, creatinine, albumin levels).
- Postoperative (ICU and hospital): Collection of complication incidence, mortality (all causes and LATA-related).
- Follow-up (by phone at 3, 6, and 12 months): CFS and EuroQoL scores, prevalence of chronic pain and analgesic use, dialysis dependency, accommodation status, readmission rates, and death date if applicable.
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: Simon CARRE, MD
- Número de telefone: +33 0556795679
- E-mail: simon.carre@chu-bordeaux.fr
Locais de estudo
-
-
France
-
Bordeaux, France, França, 33076
- Recrutamento
- University Hospital, Bordeaux
-
Contato:
- Simon CARRE, MD
- Número de telefone: +33 0556795679
- E-mail: simon.carre@chu-bordeaux.fr
-
-
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
Inclusion Criteria:
Patients aged ≥ 75 years who are affiliated with or beneficiaries of a social security scheme and undergoing emergency cardiac surgery under cardiopulmonary bypass, either immediate or urgent (relative) :
- Immediate emergency surgery: intervention performed before the start of the next working day following the decision to operate,
- Urgent (relative) emergency surgery: patients not admitted electively for surgery but requiring an intervention during the current hospital stay for medical reasons, and who cannot be discharged without undergoing a definitive procedure
Exclusion Criteria:
- Patients requiring preoperative cardiopulmonary resuscitation
- Scheduled (elective) surgery
- Lack of informed consent
- Impaired consciousness at the time of inclusion (defined by a Glasgow Coma Scale score < 15)
- Individuals under legal guardianship or judicial protection
- Individuals participating in another interventional research protocol
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Prevenção
- Alocação: Não randomizado
- Modelo Intervencional: Atribuição de grupo único
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Experimental: Frail group
Patients with Clinical Frailty Score CFS ≥ 4
|
Phone calls will be made at 3, 6, and 12 months to report quality of life scores (EuroQol EQ 5D-5L) and other postoperative data
|
|
Experimental: Non-frail group
Patients with Clinical Frailty Score CFS < 4
|
Phone calls will be made at 3, 6, and 12 months to report quality of life scores (EuroQol EQ 5D-5L) and other postoperative data
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Quality-Adjusted Life Years (QALYs) according to preoperative frailty status
Prazo: Month 12
|
QALYs over the 12-month follow-up will be estimated from EQ-5D-5L utility scores collected at baseline, Month 3, Month 6, and Month 12 together with survival data, and compared between participants with preoperative frailty (Clinical Frailty Scale ≥4) and those without frailty (Clinical Frailty Scale <4), with adjustment for EuroSCORE II.
|
Month 12
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Postoperative complications
Prazo: From surgery through,Day 28
|
Incidence of postoperative cardiac, respiratory, renal, infectious, and neurological complications during the first 28 postoperative days.
|
From surgery through,Day 28
|
|
All-cause mortality
Prazo: Through Month 12
|
All-cause mortality assessed during ICU stay, hospital stay, and at Month 3, Month 6, and Month 12.
|
Through Month 12
|
|
EQ-5D-5L Utility Index
Prazo: Baseline, Month 3, Month 6, and Month 12
|
Health-related quality of life assessed using the EQ-5D-5L utility index derived from the French value set
|
Baseline, Month 3, Month 6, and Month 12
|
|
Dialysis dependence
Prazo: Month 3, Month 6, and Month 12
|
Dialysis dependence among participants not receiving chronic dialysis before surgery.
|
Month 3, Month 6, and Month 12
|
|
Length of intensive care unit stay
Prazo: From ICU admission to ICU discharge (assessed up to Day 28)
|
Duration of postoperative ICU stay.
|
From ICU admission to ICU discharge (assessed up to Day 28)
|
|
Length of hospital stay
Prazo: From surgery to hospital discharge
|
Total postoperative hospital length of stay.
|
From surgery to hospital discharge
|
|
Hospital readmissions
Prazo: Month 3, Month 6, and Month 12
|
Number of hospital readmissions since discharge, assessed at each follow-up visit.
|
Month 3, Month 6, and Month 12
|
|
Chronic postoperative pain
Prazo: Month 3, Month 6, and Month 12
|
Presence of chronic pain related to cardiac surgery.
|
Month 3, Month 6, and Month 12
|
|
Analgesic consumption
Prazo: Month 3, Month 6, and Month 12
|
Type of analgesic medication and frequency of use since the previous follow-up assessment.
|
Month 3, Month 6, and Month 12
|
|
Living situation
Prazo: Month 3, Month 6, and Month 12
|
Living at home versus institutionalization during follow-up.
|
Month 3, Month 6, and Month 12
|
|
EQ-5D-5L visual analogue scale (EQ VAS)
Prazo: Baseline, Month 3, Month 6, and Month 12
|
Self-rated health status assessed using the EQ-5D-5L visual analogue scale (0-100).
|
Baseline, Month 3, Month 6, and Month 12
|
Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Simon CARRE, MD, University Hospital, Bordeaux
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- CHUBX 2025/040
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .