High Altitude, Orthopedic Surgery, Postoperative Complications
Conditions
Keywords
High-altitude population, Perioperative cohort, Orthopedic surgery
Brief summary
This study will focus on orthopedic surgery patients from high-altitude regions, utilizing smart wearables and monitoring tools to gather perioperative data, including heart rate, oxygen saturation, sleep quality, stress levels, and other relevant metrics. Regular follow-ups will assess recovery and complications, in addition to collecting medical records, lab results, imaging data, and other pertinent records. The ultimate goal is to establish a comprehensive follow-up cohort of orthopedic surgery patients from high-altitude areas.
Detailed description
Prolonged exposure to hypoxic and low-pressure environments leads to structural remodeling and functional abnormalities in the cardiovascular, respiratory, and hematological systems of high-altitude populations. This elevates the risk of postoperative complications, particularly in patients undergoing orthopedic surgery, significantly impacting their recovery and quality of life. This study will focus on orthopedic surgery patients from high-altitude regions. Using smart wearable devices and other monitoring tools, comprehensive perioperative dynamic data of participants, including heart rate, heart rate variability, oxygen saturation, respiratory rate, sleep quality, activity levels, stress index, and other relevant indicators will be collected. Regular follow-ups will be conducted to evaluate postoperative recovery and monitor the incidence of perioperative complications. Additionally, perioperative data such as electronic medical records, laboratory test results, ECG waveforms, echocardiography, chest CT images, and other pertinent records will be also collected. Through that, this study aims to establish a follow-up cohort of orthopedic surgery patients from high-altitude regions.
Interventions
None listed
Sponsors
West China Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age ≥ 18 years; 2. ASA classification I-III; 3. Patients who have lived at an altitude above 2500 meters for more than 6 months ; 4. Patients scheduled for elective orthopedic surgery.
Exclusion criteria
1. Urgent or emergent surgery; 2. Expected hospital stay \< 48 hours; 3. Inability to provide informed consent； 4. Patients who have been out of high-altitude regions for over three months.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative venous thromboembolism | During hospitalization | Defined according to the European Perioperative Clinical Outcome (EPCO) criteria, including both deep vein thrombosis and pulmonary embolism. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative major adverse cardiovascular events | During hospitalization | Defined according to the European Perioperative Clinical Outcome (EPCO) criteria, including non-fatal cardiac arrest, acute myocardial infarction, congestive heart failure, new cardiac arrhythmias, angina, et al. |
| Postoperative nausea and vomiting | During hospitalization | Nausea and vomiting |
| The quality of postoperative recovery | During hospitalization | Assessed using QoR-15 score at different time points after surgery |
| Chronic pain after surgery | Up to 1 year postoperatively | Assessed using NRS scale and BPI at different time points after surgery |
| Postoperative quality of life assessment | Up to 1 year postoperatively | Assessed using WHODAS2.0 scores at different time points after surgery |
| A composite of postoperative pulmonary complications | During hospitalization | Defined according to the European Perioperative Clinical Outcome (EPCO) criteria, including respiratory infection, respiratory failure, pleural effusion, atelectasis, pneumothorax, bronchospasm, and aspiration pneumonia. |
| Postoperative venous thromboembolism | Up to 2 weeks postoperatively | Defined according to the European Perioperative Clinical Outcome (EPCO) criteria, including both deep vein thrombosis and pulmonary embolism. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Postoperative cognitive function assessment | Up to 1 year postoperatively | Assessed using AD-8 and three-word recall test scores at different time points after surgery |
| Pain scores of movement-evoked pain | During hospitalization | Assessed using NRS scale and BPI at different time points after surgery |
| Pain scores at rest | During hospitalization | Using NRS scale and BPI at different time points after surgery |
| Surgical site infection | During hospitalization | Defined according to the European Perioperative Clinical Outcome (EPCO) criteria |
| Time of Bowel function recovery | During hospitalization | Defined as time to first defecation or flatus |
| Sleep quality after surgery | Up to 1 year postoperatively | Assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Morningness-Eveningness Questionnaire (MEQ) at different time points after surgery |
| Postoperative anxiety assessment | Up to 1 year postoperatively | Assessed using GAD-7 scores at different time points after surgery |
| Postoperative depression assessment | Up to 1 year postoperatively | Assessed using PHQ-9 scores at different time points after surgery |
Contacts
Primary ContactChunling Jiang, PhD
Backup ContactFengming Luo, phD
Outcome results
None listed