Frailty in Adult Surgery
Conditions
Keywords
Heart rate variability, prehabilitation, major surgery, frailty, physiological reserve
Brief summary
This prospective, observational cohort study investigates heart rate variability (HRV) monitoring using the Analgesia Nociception Index (ANI) monitor in adult patients undergoing major surgery within a multimodal rehabilitation program. The objective is to correlate HRV indices with functional capacity, physiological reserve, and frailty during the prehabilitation phase.
Detailed description
The study evaluates HRV using the ANI monitor to determine adaptation to training load, optimize analgesic and anesthetic dosing, and predict postoperative complications. The HRV indices of Energy (SDNN) and ANI (HFnu) are monitored at two points: the initial pre-anesthesia consultation and one week before surgery. Results will be compared with the 6-minute walk test, MUST nutrition screening scale, and clinical frailty and FRAIL scales.
Interventions
Non-invasive monitoring of HRV to evaluate autonomic nervous system activity using the indices of Energy (SDNN) and ANI (HFnu).
BEHAVIORALTrimodal Prehabilitation
Program of physical exercise, nutritional supplementation, and psychological support according to the RICA guidelines of the Spanish Group for Multimodal Rehabilitation.
Sponsors
Investigation Group Anesthesia, Resuscitation, And Perioperative Medicine of Aragon
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients over 18 years of age * Scheduled for major adult surgery * Any ASA classification * Signed informed consent
Exclusion criteria
* Urgent surgery * Severe cognitive impairment * Patient refusal to participate * Pediatric patients * Cardiac arrhythmia or atrial fibrillation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Correlation of HRV indices with functional capacity and frailty | From initial pre-anesthesia consultation to 30 days postoperatively | Evaluation of the correlation between HRV indices (Energy and ANI) and current parameters used to assess functional capacity, physiological reserve, and frailty. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Reduction of postoperative complications | 30 days postoperatively | Evaluation of the relationship between higher preoperative functional reserve and lower number of complications, mortality, and hospital stay at 30 days postoperatively. |
| Intraoperative decisions based on HRV | During the perioperative period | Analysis of whether HRV monitoring guides the workload during prehabilitation and the titration of drugs during surgery. |
Countries
Spain
Contacts
Primary ContactCristian Aragón-Benedí, M.D., Ph.D.,
Outcome results
None listed