SAGE-Heart : Senior Assessment fraGility and Post-opErative QALYs 1 Year After Emergency HEART Surgery for Patients Aged 75 and Older (SAGE-Heart)
研究概览
详细说明
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.
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习联系方式
- 姓名:Simon CARRE, MD
- 电话号码:+33 0556795679
- 邮箱:simon.carre@chu-bordeaux.fr
学习地点
-
-
France
-
Bordeaux、France、法国、33076
- 招聘中
- University Hospital, Bordeaux
-
接触:
- Simon CARRE, MD
- 电话号码:+33 0556795679
- 邮箱:simon.carre@chu-bordeaux.fr
-
-
参与标准
资格标准
适合学习的年龄
- 年长者
接受健康志愿者
描述
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
学习计划
研究是如何设计的?
设计细节
- 主要用途:预防
- 分配:非随机化
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的: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
|
|
实验性的:Non-frail group
Patients with Clinical Frailty Score CFS < 4
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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
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Quality-Adjusted Life Years (QALYs) according to preoperative frailty status
大体时间: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.
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Month 12
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Postoperative complications
大体时间:From surgery through,Day 28
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Incidence of postoperative cardiac, respiratory, renal, infectious, and neurological complications during the first 28 postoperative days.
|
From surgery through,Day 28
|
|
All-cause mortality
大体时间:Through Month 12
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All-cause mortality assessed during ICU stay, hospital stay, and at Month 3, Month 6, and Month 12.
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Through Month 12
|
|
EQ-5D-5L Utility Index
大体时间:Baseline, Month 3, Month 6, and Month 12
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Health-related quality of life assessed using the EQ-5D-5L utility index derived from the French value set
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Baseline, Month 3, Month 6, and Month 12
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Dialysis dependence
大体时间:Month 3, Month 6, and Month 12
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Dialysis dependence among participants not receiving chronic dialysis before surgery.
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Month 3, Month 6, and Month 12
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Length of intensive care unit stay
大体时间:From ICU admission to ICU discharge (assessed up to Day 28)
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Duration of postoperative ICU stay.
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From ICU admission to ICU discharge (assessed up to Day 28)
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Length of hospital stay
大体时间:From surgery to hospital discharge
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Total postoperative hospital length of stay.
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From surgery to hospital discharge
|
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Hospital readmissions
大体时间:Month 3, Month 6, and Month 12
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Number of hospital readmissions since discharge, assessed at each follow-up visit.
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Month 3, Month 6, and Month 12
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|
Chronic postoperative pain
大体时间:Month 3, Month 6, and Month 12
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Presence of chronic pain related to cardiac surgery.
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Month 3, Month 6, and Month 12
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Analgesic consumption
大体时间:Month 3, Month 6, and Month 12
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Type of analgesic medication and frequency of use since the previous follow-up assessment.
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Month 3, Month 6, and Month 12
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Living situation
大体时间:Month 3, Month 6, and Month 12
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Living at home versus institutionalization during follow-up.
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Month 3, Month 6, and Month 12
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EQ-5D-5L visual analogue scale (EQ VAS)
大体时间:Baseline, Month 3, Month 6, and Month 12
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Self-rated health status assessed using the EQ-5D-5L visual analogue scale (0-100).
|
Baseline, Month 3, Month 6, and Month 12
|
合作者和调查者
调查人员
- 首席研究员:Simon CARRE, MD、University Hospital, Bordeaux
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- CHUBX 2025/040
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
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