Status:

COMPLETED

Pilot Testing a Home-Based Rehabilitation Intervention Designed to Improve Outcomes of Frail Veterans Following Cardiothoracic Surgery

Lead Sponsor:

VA Office of Research and Development

Conditions:

Coronary Artery Bypass Graft

Non-cardiac Thoracic Surgery

Eligibility:

All Genders

Phase:

NA

Brief Summary

Frail Veterans are at increased risk for poor surgical outcomes, and as the Veteran population grows older and more frail, there is a critical need to identify effective strategies for reducing surgic...

Detailed Description

Background: Frail Veterans are at increased risk for poor surgical outcomes. Although surgical techniques have advanced to a level where surgery on very old adults is feasible, if a patient is also fr...

Eligibility Criteria

Inclusion

  • Veteran patient scheduled for Coronary artery bypass graft (CABG), valve surgery, or other non-cardiac thoracic surgery;
  • Demonstrate at least mild frailty (e.g., Risk Analysis Index \[RAI\]\>=16).
  • Physician/provider request for patients with RAI\<16.

Exclusion

  • Emergent, urgent, or otherwise time-sensitive surgery that precludes prehabilitation;
  • Unstable or recent unstable cardiac syndrome as defined by (a) acute coronary syndrome within 6 weeks; (b) decompensated heart failure; (c) New York Heart Association Class IV Heart Failure; (d) unstable angina; (e) Canadian Cardiovascular Society Class IV symptoms; (f) critical left main coronary disease; (g) clinically significant arrhythmias,
  • Severe valvular heart disease: (a) severe aortic or mitral stenosis (aortic or mitral valve area \<1.0 cm2 or mean gradient \>40 or \>10 mm Hg, respectively)
  • Dynamic LV (Left Ventricle) outflow obstruction
  • Physical, cognitive, social or logistical limitations preventing participation in the prehabilitation regimen, including:
  • Patients who require surrogate consent for the planned surgery
  • Patients with court orders of incompetence or clinical determinations of incapacity documented in the medical record
  • Clinical exam by study physician consistent with incapacity
  • Patients who at any time during prehabilitation or longitudinal follow up demonstrate insufficient cognitive capacity to safely and effectively carry out the prescribed activities.
  • Unable to speak English.
  • Surgery is cancelled by IMPACT clinic or surgeon due to unacceptable risk.

Key Trial Info

Start Date :

November 22 2017

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

September 30 2020

Estimated Enrollment :

35 Patients enrolled

Trial Details

Trial ID

NCT03299101

Start Date

November 22 2017

End Date

September 30 2020

Last Update

January 13 2021

Active Locations (1)

Enter a location and click search to find clinical trials sorted by distance.

Page 1 of 1 (1 locations)

1

VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA

Pittsburgh, Pennsylvania, United States, 15240