Team-based care planning before surgery for older patients with heart failure
Tests a team-based care plan before surgery in older adults with heart failure.
Plain-language title generated from the registry record
Registry title: Perioperative Interdisciplinary, Intersectoral Process Optimization in Heart Failure
Key facts
- Where
- Giessen, GermanySee the site
Where in Germany
- Justus Liebig University Giessen, University Hospital Giessen and MarburgGiessen, GermanyTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- University of Giessen
- Trial code
- NCT06381427
- Record updated
- 3 March 2025
- Original description
Chronic heart failure affects up to three million people in Germany, with prevalence increasing with age. It is a leading cause of cardiovascular disease-related deaths. Patients with heart failure undergoing non-cardiac surgery face higher risks of complications and death compared to those with coronary artery disease. Despite guidelines recommending comprehensive preoperative evaluation, there is no systematic risk assessment structure in place, leading to inadequate perioperative care. This study aims to evaluate a multidisciplinary approach for high-risk patients aged 65 and above, regardless of prior heart failure diagnosis, to mitigate postoperative complications. The investigators measure the NTpro BNP before surgery and include patients with NTproBNP> 450 in this study and randomize them either to the standard care group or the intervention group.The hypothesis is that standardized risk screening and multidimensional care (Intervention group) can reduce complications in these patients undergoing non-cardiac surgery.Read full original descriptionShow less
Perioperative Interdisciplinary, Intersectoral Process Optimization in Heart Failure: A Multicenter, Prospective-randomized Intervention Study
Chronic heart failure affects up to three million people in Germany, with prevalence increasing with age. It is a leading cause of cardiovascular disease-related deaths. Patients with heart failure undergoing non-cardiac surgery face higher risks of complications and death compared to those with coronary artery disease. Despite guidelines recommending comprehensive preoperative evaluation, there is no systematic risk assessment structure in place, leading to inadequate perioperative care. This study aims to evaluate a multidisciplinary approach for high-risk patients aged 65 and above, regardless of prior heart failure diagnosis, to mitigate postoperative complications. The investigators measure the NTpro BNP before surgery and include patients with NTproBNP> 450 in this study and randomize them either to the standard care group or the intervention group.The hypothesis is that standardized risk screening and multidimensional care (Intervention group) can reduce complications in these patients undergoing non-cardiac surgery.
Inclusion: Age ≥ 65 years; Elective non-cardiac surgical operation with intermediate or high operative risk under general anesthesia or combined anesthesia (general and regional anesthesia) as per Figure 1; ASA (American Society of Anesthesiologists) grade ≥ II; Qualification for randomization: NT-proBNP ≥ 450pg/ml during routine preoperative evaluation and anesthesia consultation.
Exclusion: Transplantation surgery (e.g., kidney, liver, lung transplantation); Kidney surgery (e.g., nephrectomy, partial nephrectomy); Emergency surgery; Surgery under general anesthesia within the last 30 days; Surgical time < 30 minutes; Cardiac surgery and cardiology interventional procedures; Chronic kidney insufficiency with eGFR < 15 ml/min or dialysis-dependent kidney insufficiency; Age < 65 years; Procedures involving cardiopulmonary bypass; Primary use of local or regional anesthesia; Participation in another interventional study; Lack of consent; Limited language proficiency; Patient's limited or absent capacity to provide consent, as well as patients under legal guardianship.