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Evaluation of Wearables for Preoperative Cardiorespiratory Fitness Screening and Risk Stratification in Geriatric Surgery

可穿戴设备在老年手术中进行术前心肺健康筛查和风险分层的评估

基本信息

批准号：
10450122
负责人：
Richard Boyer
金额：
$ 16.95万
依托单位：
WEILL MEDICAL COLL OF CORNELL UNIV
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-15 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10450122
关键词：
Activities of Daily Living Address Adult Aerobic Exercise Age Aging Agreement Anesthesiology Applications Grants Behavioral Research Cardiopulmonary Caring Chronic Disease Clinical Research Data Decision Making Development Devices Disease Management Education Elderly Energy Metabolism Enhancement Technology Evaluation Exercise Exercise Test Exercise Therapy Foundations Future Geriatrics Gold Health Technology Healthcare Heart Rate Human Resources Indirect Calorimetry Individual Intervention Knowledge Logistics Measurement Measures Medical Memorial Sloan-Kettering Cancer Center Modeling Monitor Morbidity - disease rate Oncology Operative Surgical Procedures Outcome Oxygen Palliative Medicine Patient-Focused Outcomes Patients Perioperative Perioperative complication Physiologic Monitoring Physiological Physiology Pilot Projects Population Postoperative Complications Postoperative Period Predictive Value Protocols documentation Provider Public Health Quality of life Recovery Research Risk Risk Assessment Schedule Surgical complication System Testing United States Variant Walking Work Workload aged aging and technology base cardiorespiratory fitness clinical practice comorbidity cost effective disability equipment training exercise intensity exercise intervention exercise program experience fitness frailty hemodynamics high risk human old age (65+)improved medical schools metabolic rate mortality multisensory older patient perioperative morbidity perioperative mortality predictive modeling prospective risk stratification screening sex signal processing surgery outcome surgical risk tool trend uptake wearable device

项目摘要

PROJECT SUMMARY Major surgeries are becoming increasingly common in older adults with approximately half of the population over the age of 65 years requiring surgery at least once during the remainder of their lives. This trend is highly concerning for public health, because older adults are well known to suffer high rates of postoperative morbidity and mortality following major surgeries due to diminished functional capacity, comorbidities, frailty, and lack of access to comprehensive geriatric care. Preoperative risk stratification is of particular importance in geriatric surgery to identify patients at increased risk of surgical complications, to fully inform patients and providers in their surgical decision-making, and to determine if additional preoperative testing or medical interventions are required prior to surgery. Functional capacity as measured by maximum oxygen uptake (VO2peak), is an important factor in older adults presenting for major surgery, because it is highly correlated to postoperative morbidity and mortality, provides a holistic picture of cardiorespiratory fitness, and is modifiable with prehabilitation exercise programs. Although direct measurement of maximum oxygen uptake is possible with sophisticated cardiopulmonary exercise testing (CPET), wide-scale implementation of this measurement is not practical due to the need for specialized equipment, trained personnel, and financial and logistical challenges. Wearable fitness monitors capable of remote mobility and physiology monitoring offer an alternative to direct cardiopulmonary exercise measurement through indirect prediction of functional capacity using cardiorespiratory fitness metrics, such as exercise intensity and heart rate reserve. The proposed research aims to: (1) assess the accuracy of wearable devices for predicting VO2peak in older adults; and (2) evaluate the odds of perioperative complications using wearable-predicted VO2peak in older adults undergoing major noncardiac surgery. A prospective observational clinical study will be conducted to measure preoperative wearable fitness monitor data and gold-standard CPET-measured VO2peak in older adults scheduled for major surgery at Weill Cornell Medical College. This project will be the first to use wearable fitness monitors for preoperative cardiorespiratory fitness screening and risk stratification in older adults, and will set the stage for future studies of wearable protocols for surgical risk stratification in older adults and wearable-guided prehabilitation interventions. The contribution will be significant because it is expected to improve preoperative screening in vulnerable older adults scheduled for major surgery with practical, cost effective and accessible consumer health technology.

项目总结