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

• 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
• 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

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.

项目摘要 在大约一半人口的老年人中，主要手术变得越来越普遍 在65岁的超过65岁以上，在其余生中至少需要一次手术。这种趋势很高 关于公共卫生，因为众所周知，老年人术后遭受高率 由于功能能力降低，合并症，脆弱，脆弱性，发病率和死亡率 并且缺乏获得全面的老年护理。术前风险分层在 老年手术可以鉴定出患有手术并发症风险增加的患者，以充分告知患者和 提供者在手术决策中，并确定术前测试或医疗 在手术前需要进行干预措施。通过最大吸收量来衡量的功能能力 （vo2peak），是用于大手术的老年人的重要因素，因为它与 术后发病率和死亡率，提供心肺健康的整体图片，并且是可修改的 与居住锻炼计划。尽管可以直接测量最大摄入量 随着复杂的心肺运动测试（CPET），此测量的广泛实施是 由于需要专业设备，训练有素的人员以及财务和后勤方 挑战。可穿戴健身监视器，能够进行远程移动和生理监测提供 通过间接预测功能能力的替代直接心肺运动测量 使用心肺健身指标，例如运动强度和心率储备。提议 研究的目的是：（1）评估可穿戴设备预测老年人VO2PEAK的准确性； （2） 使用可穿戴可穿戴的老年人使用可穿戴可穿戴的VO2PEAK评估围手术期并发症的几率 主要的非心脏手术。将进行一项前瞻性观察性临床研究，以测量术前研究 可穿戴健身监视器数据和金色标准的CPET CPET vo2peak的老年人计划为专业 威尔·康奈尔医学院的手术。该项目将是第一个使用可穿戴健身监视器的项目 术前心肺健身筛查和老年人的风险分层，并将为 未来研究老年人手术风险分层的可穿戴方案和可穿戴的研究 居住干预措施。该贡献将是重要的，因为有望改善术前 筛查计划进行大手术的脆弱老年人，具有实用，具有成本效益且易于访问的 消费者卫生技术。