analysis of frailty syndrome within the framework of the innovation fund project präp-go (ana-präp-go)

Conditions: Frailty Syndrome

Summary: the patients included in präp-go and the corresponding comparison cohorts will be offered to participate in this complementary study in order to be able to carry out a detailed characterization and phenotyping of the frailty complex. amendment vote of 08/05/2024: recruitment extension of non-frail surgical control group (nfc cohort) until august 31, 2025.

as part of the innovation fund project präp-go (ea1/225/19), a multimodal intervention is being conducted in patients with a frailty syndrome. however, the health care research project is limited to evaluating clinical issues only. in order to be able to research further pathophysiological, clinical, psychosocial and work-organizational connections, different groups of participants will be offered the participation in this scientific support program of präp-go. the groups of participants in this accompanying program ana-präp-go are: * randomized study patients with a frailty syndrome of the intervention study präp-go (pg cohort) * non-frail surgical control group (nfc cohort) * non-surgical comparison group (no cohort) * participants with health professions (gb cohort) additionally, relatives of the patients can be included. subprojects are included to reflect research questions of interest in sub groups: * success of endoprosthetic implants (clinical outcome and gait pattern after total hip arthroplasty and total knee arthroplasty in frail patients) * functional treatment outcome and health-related quality of life after elective spinal surgery in the pg cohort, in the nfc cohort, and in the no cohort * hemodynamic evaluation in patients of the pg and nfc cohort with preoperative abnormal cardiovascular function * establishment of a german standard database for 14 cantab tests by cantab connect technology * aggregated evaluation of the cognitive data of different surgical cohorts from studies carried out at the department of anesthesiology to describe domain-specific changes in the perioperative course * perspectives of different health professional groups regarding barriers and facilitators in the implementation of a prehabilitation program and necessary changes in skill, organizational and management, and communication in an interdisciplinary setting * perspectives of patients and significant others regarding the organizational pathway of the prehabilitation program * frequency, pathophysiology and trajectory of muscle weakness as well as functional impairments of patients admitted to intensive care units of the pg and nfc cohort and their long-term outcomes. * the gut microbiome as a potential risk factor for perioperative neurocognitive disorders (pnds) in the elderly * evaluation of nutrition data in all cohorts (e.g. adherence to mediterranean diet, nutrition habits, nutritional status, dental status etc.)

Eligibility criteria:
pg cohort: inclusion criteria * consent given and inclusion in präp-go * patient capable of giving consent or existing legal guardian in the case of patients not capable of giving consent exclusion criteria - none nfc cohort: inclusion criteria * patient capable of giving consent or existing legal guardian in the case of patients not capable of giving consent * age ≥ 70 years * elective surgery planned * expected anesthesia duration\> 60 min * no frailty syndrome (0 positive out of 5 standardized parameters) according to the physical frailty phenotype (fried et al., 2001) exclusion criteria * severe cardiac or pulmonary disease (nyha iv, gold iv) * intracranial interventions * moribund patients (palliative situation) * patients with a neuropsychiatric clinical picture or severe hearing and / or visual acuity impairment (not compensated by visual or hearing aids), which limit the performance of the neurocognitive tests * insufficient language skills * participation in another interventional rehabilitation study or a study according to the german drug law or the medical device law that has not been approved by the study leader (exception: parallel participation in adjuvant therapy study). no cohort: inclusion criteria - age ≥ 70 years * no elective surgery planned * no surgery within 6 months prior to study enrollment exclusion criteria - see nfc cohort gb cohort: inclusion criterion - doctor, nurse or therapist from the cooperation partners of praep-go who were involved in the project exclusion criterion - language barrier relatives: inclusion criteria * member of a patient in the präp-go cohort * age ≥ 18 years exclusion criterion - language barrier