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SAGE-Heart : Senior Assessment fraGility and Post-opErative QALYs 1 Year After Emergency HEART Surgery for Patients Aged 75 and Older (SAGE-Heart)

29 juni 2026 uppdaterad av: University Hospital, Bordeaux
The hypothesis is that the preoperative Clinical Frailty Score (CFS) is a predictive factor for a loss in quality-adjusted life years (QALYs) one year after emergency cardiac surgery under cardiopulmonary bypass (CPB) in patients aged 75 years and older.

Studieöversikt

Status

Rekrytering

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Beräknad)

265

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

  • Frankrike
    • France
      • Bordeaux, France, Frankrike, 33076

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

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

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Icke-randomiserad
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Frail group
Patients with Clinical Frailty Score CFS ≥ 4
Övrig: Phone Calls
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
Experimentell: Non-frail group
Patients with Clinical Frailty Score CFS < 4
Övrig: Phone Calls
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

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Quality-Adjusted Life Years (QALYs) according to preoperative frailty status
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Postoperative complications
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: From surgery to hospital discharge
Total postoperative hospital length of stay.
From surgery to hospital discharge
Hospital readmissions
Tidsram: 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
Tidsram: Month 3, Month 6, and Month 12
Presence of chronic pain related to cardiac surgery.
Month 3, Month 6, and Month 12
Analgesic consumption
Tidsram: 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
Tidsram: 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)
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

University Hospital, Bordeaux

Utredare

  • Huvudutredare: Simon CARRE, MD, University Hospital, Bordeaux

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

3 december 2025

Primärt slutförande (Beräknad)

3 december 2028

Avslutad studie (Beräknad)

3 december 2028

Studieregistreringsdatum

Först inskickad

18 juni 2026

Först inskickad som uppfyllde QC-kriterierna

29 juni 2026

Första postat (Faktisk)

30 juni 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

30 juni 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

29 juni 2026

Senast verifierad

1 juni 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • CHUBX 2025/040

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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