Perioperative Management of Risk Factors in the Elderly Patients

NCT04967872 | Completed DMC

• 1 other identifier: TJ-IRB20210634
• Study Type: interventional
• Target: 4,782
• Locations: 1 country
• Sites: 1

Brief Summary

In 2017, the number of operations on hospitalized patients in China was more than 57 million, of which more than 20 million were performed on elderly patients (≥65 years of age). As of the end of 2017, there were 143 million elderly people over 65 years old in China, of which 26 million people were 80 years old and over, accounting for 1.8% of the country's total population, and this proportion is increasing. More and more elderly patients need surgery. A study showed that compared with the 65-79-year-old population, the probability of myocardial infarction after orthopedic surgery in patients over 80 years of age increased by 2.7 times, the probability of lung infection increased by 3.5 times, and the mortality rate increased by 3.4 times. The inherent risks of surgery and increased postoperative complications in elderly patients are closely related to factors such as senile syndrome. Geriatric syndrome refers to the deterioration of the function of various organ systems as the age increases, and a series of non-specific symptoms and signs appear in the elderly, including weakness, comorbidities, cognitive dysfunction and so on. These symptoms increase with age, seriously impairing the quality of life of the elderly and increasing their perioperative risk. Taking frailty as an example, the incidence of frailty among the 65-70 years old population is 3.2%, 71-74 years old is 5.3%, 75-79 years old is 9.5%, 80-84 years old is 16.3%, and\> 85 years old is 25.1. %. On the other hand, the physical functions of the elderly are constantly degrading with age. Take skeletal muscle as an example. After the age of 50, the skeletal muscle mass decreases by 1%-2% every year with the increase of age. The chronic muscle loss of people over 60 years old is estimated to be 30%, and the elderly people over 80 years old lose up to 50%. It can be seen that the elderly patients are a special group of elderly patients, which have their particularity compared with the low-age elderly groups. Therefore, the establishment of a perioperative risk warning and control system and technical system for elderly patients to deal with the unpredictable perioperative risks caused by their weakness, comorbidities, and physical hypofunction, and to provide safety guarantees for elderly surgical patients has become an urgent problem for geriatrics.

Conditions

Perioperative Cardiavascular Complication; Peroperative Complication; Perioperative Pulmonary Complication; Perioperative Neurological Complication

Keywords

the elderly population; frailty; perioperative visualization; perioperative ultrasound; perioperative monitoring; risk evaluation and prediction; sarcopenia; delirium; acute kidney injury; pneumonia; acute myocardial injury

Outcome Measures

Primary Outcomes (1)

• The incidence of perioperative adverse events in elderly patients

  From the beginning of anesthesia induction to 30 days after surgery or discharged of hospital

Interventions

Implementing risk management and control plan for the elderly during perioperative period OTHER

Visualization technology is used for preoperative evaluation, anesthesia management, bedside real-time monitoring and intervention, etc., to achieve accurate perioperative management of elderly patients and whole-process whole-person management

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• selective surgery
• aged over 65-years-old.

You may not qualify if:

• Participating in other clinical trials within 6 months
• Patients receiving local anesthesia
• Cases with unknown outcomes

Sponsors & Collaborators

• Ailin Luo: lead
• Renmin Hospital of Wuhan University: collaborator
• Beijing Hospital: collaborator
• Chinese Academy of Medical Sciences, Fuwai Hospital: collaborator

Study Sites (1)

TongjiHospital

Wuhan, China

Location

Related Publications (1)

• Sun R, Zhou Z, Li X, Xu Q, Zhou B, Yu H, Zhang W, Sun Q, Zhang X, Luo X, Li S, Luo A. Prognostic significance of preoperative nutritional status for postoperative acute kidney injury in older patients undergoing major abdominal surgery: a retrospective cohort study. Int J Surg. 2024 Feb 1;110(2):873-883. doi: 10.1097/JS9.0000000000000861.

  PMID: 37921644 DERIVED

MeSH Terms

Conditions

Intraoperative Complications; Frailty; Sarcopenia; Delirium; Acute Kidney Injury; Pneumonia

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms; Muscular Atrophy; Neuromuscular Manifestations; Neurologic Manifestations; Nervous System Diseases; Atrophy; Pathological Conditions, Anatomical; Signs and Symptoms; Confusion; Neurobehavioral Manifestations; Neurocognitive Disorders; Mental Disorders; Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Respiratory Tract Infections; Infections; Lung Diseases; Respiratory Tract Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: July 8, 2021
• First Posted: July 20, 2021
• Study Start: September 1, 2021
• Primary Completion: March 31, 2024
• Study Completion: March 31, 2024
• Last Updated: April 15, 2025

Record last verified: 2024-03

Locations

CN (1)