Comparison of preoperative Handgrip Strength with Revised Cardiac Risk Index and Modified Frailty Index for predicting 30-day in hospital mortality and morbidity
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 340
- 试验地点
- 1
- 主要终点
- Comparison of preoperative HGS with RCRI(Revised Cardiac Risk Index) and MFI(Modified Frailty Index) to find out which one is a better predictor of 30-day post-operative mortality and morbidity.
研究概览
简要总结
Preoperative evaluation aims to identify the patients with high risk for postoperative mortality and morbidity. Different tools and imaging tests have been used to estimate the patient’s risk of perioperative cardiac complications posted for major non cardiac surgeries like Lee index, Revised Cardiac Risk Index (RCRI), Modified Frailty Index (MFI) and walking based test.Different imaging tests adds to cost and delays the surgical procedure.
Frailty is a multi-dimensional syndrome associated with perioperative mortality and morbidity and reflects inactivity, low muscle mass, and reduced energy.It consists of four domains which includes physical, psychological, cognitive and social frailty.One of the criteria of physical frailty includes strength.
The progressive and generalized decrease in amount and strength of skeletal muscle is known as sacropenia.Sacropenia has been identified as one of the risk factors associated with poor perioperative outcome and increase hospital stay in surgical patients undergoing resection of either gastrointestinal, bladder, endometrial, hepatocellular, head or neck malignancy and liver transplant surgery.Hand grip strength is one of the predictors of muscle strength and mass. Handgrip strength (HGS) measured using handgrip dynamometry is a simple, inexpensive, quick and easily accessible tool to detect sacropenia and physical frailty.
Therefore, integrating handgrip strength alongside clinical risk factors may further improve pre-operative risk stratification in patients undergoing thoracoabdominal or orthopaedic surgery. In doing so, handgrip assessment may aid in the allocation of surgical resources, may decrease expense by preventing patients from receiving costly and potentially unnecessary procedures and imaging tests.
Hence, we proposed to compare preoperative hand grip strength with Revised Cardiac Risk Score and modified Frailty Score for predicting postoperative mortality and morbidity and to correlate preoperative HGS using hand grip dynamometry with 30-day in hospital mortality and morbidity in patients undergoing thoracoabdominal or orthopaedic surgeries under general or regional anaesthesia.
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 40.00 Year(s) 至 99.00 Year(s)（—）
- 性别
- All
入选标准
- •American Society of Anesthesiologists (ASA) physical status I.
- •III Age > 40 years BMI – 18-40 kg/m2 of either sex Scheduled to undergo elective/emergency non-cardiac thoracoabdominal or orthopaedic surgery.
排除标准
- •Patient refusal to give informed consent Patients who are unable to comprehend the commands Patients ho are unable to use the dynamometer freely Haemodynamically unstable patients.
结局指标
主要结局
Comparison of preoperative HGS with RCRI(Revised Cardiac Risk Index) and MFI(Modified Frailty Index) to find out which one is a better predictor of 30-day post-operative mortality and morbidity.
时间窗: Comparison of preoperative HGS with RCRI and MFI to find out which one is a better predictor of 30-day post-operative mortality and morbidity.
次要结局
- Co-relation of preoperative HGS with 30-day outcome in terms of post-operative complications within 7 days, need for ICU admission/ventilatory support, length of hospital stay, in-hospital morbidity/mortality and METs scale pre-operatively and on post op day 7, 15 & 30.(Preoperatively and Postoperative day 7, 15 and 30)