NCT02668250

Brief Summary

With the increasing aging population demographics and life expectancies, the number of very elderly patients undergoing surgery is rising. Elderly patients constitute an increasingly large proportion of the high-risk surgical group. Cardiac complications and postoperative pulmonary complications are equally prevalent and contribute similarly to morbidity, mortality, and length of hospital stay. Specific optimization strategy of general anesthesia has been tested in high-risk patients undergoing major surgery to improve outcomes. Our hypothesis is that a combined optimization strategy of anesthesia concerning hemodynamic, ventilation, and depth of anesthesia may improve short- and long- term outcome in elderly undergoing high risk surgery.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
2,495

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Feb 2017

Longer than P75 for not_applicable

Geographic Reach
1 country

29 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 22, 2016

Completed
7 days until next milestone

First Posted

Study publicly available on registry

January 29, 2016

Completed
1 year until next milestone

Study Start

First participant enrolled

February 3, 2017

Completed
3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 5, 2020

Completed
1.1 years until next milestone

Study Completion

Last participant's last visit for all outcomes

March 16, 2021

Completed
Last Updated

August 26, 2021

Status Verified

August 1, 2021

Enrollment Period

3 years

First QC Date

January 22, 2016

Last Update Submit

August 25, 2021

Conditions

Outcome Measures

Primary Outcomes (1)

  • Incidence of a composite of mortality or major postoperative morbidity.

    One or more of major postoperative complications : acute kidney injury (defined by Kidney disease : improving Global Outcomes (KDIGO) stage 1 or higher), acute myocardial infarction, heart failure, stroke, development of sepsisand septic shock, acute respiratory failure requiring non-invasive ventilation or intubation, delirium) will be reported in the source folder of the patients, and the mortality will be also focused. The goal of this study is to decrease this incidence.

    Day 30

Study Arms (2)

Experimental group : OPTI-AGED

EXPERIMENTAL

The OPTI-AGED group will receive a combined optimization strategy of anesthesia concerning hemodynamic, ventilation, and depth of anesthesia.

Procedure: OPTI-AGED

Control Group :

ACTIVE COMPARATOR

The control group will not benefit from the OPTI-AGED intervention but patients will receive the usual care.

Procedure: Usual Care

Interventions

OPTI-AGEDPROCEDURE

OPTI-AGED is composed of a multi-parametric optimization strategy.

Experimental group : OPTI-AGED
Usual CarePROCEDURE

Patients receive the usual care.

Control Group :

Eligibility Criteria

Age75 Years+
Sexall
Healthy VolunteersNo
Age GroupsOlder Adult (65+)

You may qualify if:

  • All adult patients aged 75 years and over,
  • presenting at least one of the following comorbidities: ischemic coronary disease; cardiac arrhythmia; congestive heart failure; peripheral vascular disease; dementia; stroke; chronic obstructive pulmonary disease; chronic respiratory failure; chronic alcohol abuse; active cancer; diabetes; chronic renal failure A comorbidity index will be measured by using the modified Charlson Comorbidity Index
  • undergoing elective and emergency surgeries including : femoral head fracture, major intraperitoneal abdominal surgery lasting \> 90 min (excluding elective cholecystectomy, abdominal wall surgery), vascular surgery (excluding venous surgery and fistula creation)
  • Patient's or patient's relative signed consent form
  • Affiliation to French social assurance system

You may not qualify if:

  • Acute heart failure and acute coronary syndrome
  • Acute respiratory failure, pneumonia
  • Septic shock
  • Delirium
  • Acute stroke
  • Evolutive neuromuscular disorder
  • Thoracic surgery, combined abdominal and thoracic surgery
  • Surgery performed under exclusive regional anesthesia
  • Patients under tutorship or curatorship
  • Refusal to participate

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (29)

CHU Amiens - Picardie

Amiens, France

Location

CHU CAEN

Caen, France

Location

Chu Clermont-Ferrand

Clermont-Ferrand, 63003, France

Location

Médipôle Lyon - Villeurbanne

Décines-Charpieu, France

Location

Chu Dijon

Dijon, 21079, France

Location

Chu Grenoble

Grenoble, 38043, France

Location

CHRU Lille - Salengro

Lille, 59000, France

Location

CHU LILLE - Huriez

Lille, 59037, France

Location

CHU LYON

Lyon, France

Location

Lyon Sud - CHU

Lyon, France

Location

Chu Marseille La Timone

Marseille, 13385, France

Location

Chu Marseille Nord

Marseille, 13385, France

Location

Chu Montpellier

Montpellier, 34295, France

Location

Chu Nancy

Nancy, 54035, France

Location

CHU de Nantes

Nantes, France

Location

CHU NICE

Nice, France

Location

Chu Nimes

Nîmes, France

Location

Ch Paris Beaujon

Paris, France

Location

Ch Paris Bichat

Paris, France

Location

Ch Paris Pitie Salpetriere

Paris, France

Location

Ch Paris Saint Antoine

Paris, France

Location

Ch Saint Louis-Lariboisiere

Paris, France

Location

Chu Poitiers

Poitiers, 86021, France

Location

Chu Rennes

Rennes, France

Location

Chu Rouen

Rouen, 76031, France

Location

Chu Saint Etienne

Saint-Etienne, 42100, France

Location

Hopital Central Strasbourg

Strasbourg, 67098, France

Location

Hopital Hautepierre Strasbourg

Strasbourg, 67098, France

Location

Chu Toulouse

Toulouse, 31059, France

Location

Related Publications (1)

  • Molliex S, Passot S, Futier E, Bonnefoi M, Rancon F, Lemanach Y, Pereira B. Stepped wedge cluster randomised controlled trial to assess the effectiveness of an optimisation strategy for general anaesthesia on postoperative morbidity and mortality in elderly patients (the OPTI-AGED study): a study protocol. BMJ Open. 2018 Jun 19;8(6):e021053. doi: 10.1136/bmjopen-2017-021053.

MeSH Terms

Conditions

IschemiaArrhythmias, CardiacHeart FailurePeripheral Vascular DiseasesDementiaStrokePulmonary Disease, Chronic ObstructiveRespiratory InsufficiencyAlcoholismNeoplasmsDiabetes MellitusRenal Insufficiency

Condition Hierarchy (Ancestors)

Pathologic ProcessesPathological Conditions, Signs and SymptomsHeart DiseasesCardiovascular DiseasesVascular DiseasesBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesNeurocognitive DisordersMental DisordersCerebrovascular DisordersLung Diseases, ObstructiveLung DiseasesRespiratory Tract DiseasesChronic DiseaseDisease AttributesRespiration DisordersAlcohol-Related DisordersSubstance-Related DisordersChemically-Induced DisordersGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System DiseasesKidney DiseasesUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital Diseases

Study Officials

  • MOLLIEX Serge, MD

    CHU SAINT-ETIENNE

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
SUPPORTIVE CARE
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 22, 2016

First Posted

January 29, 2016

Study Start

February 3, 2017

Primary Completion

February 5, 2020

Study Completion

March 16, 2021

Last Updated

August 26, 2021

Record last verified: 2021-08

Data Sharing

IPD Sharing
Will not share

Locations