About this trial
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.
Eligibility criteria
Qualifiers
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.
Disqualifiers
Age < 65 years
Cardiac surgery and cardiology interventional procedures
Transplantation surgery (e.g., kidney, liver, lung transplantation)
Kidney surgery (e.g., nephrectomy, partial nephrectomy)
Trial design
Treatments tested in this trial
- Interdisciplinary decision-making for perioperative care
Treatment groups
Sponsors and collaborators
University of Giessen
Lead sponsor
Deutsche Luft und Raumfahrt
Collaborator