Level of Accelerometer-assessed Preoperative Physical Activity and Short Term Outcome After Elective Cardiac Surgery

Study Overview
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Brief Summary
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Short term morbidity after elective cardiac surgery remains significant. Standard predictive models, considering simple patient demographics and clinical parameters, show limited efficiency in individual operative risk assessment. There is growing evidence about daily physical activity as a relevant indicator of preoperative frailty. Although cardiopulmonary exercise testing remains a gold standard, we are looking for more simple tools in order to identify patients with poor physical condition. Accelerometry may be an objective and reproductible method to measure physical activity at patient's home.

Detailed Description
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The aim of this study is to compare accelerometer-assessed preoperative physical activity between two groups of patients with different postoperative length of stay following elective cardiac surgery. In the future, accelerometry could be used to identify patients that may benefit from prehabilitation programs including exercise therapy before elective cardiac surgery.

Official Title
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Level of Accelerometer-assessed Preoperative Physical Activity and Short Term Outcome After Elective Cardiac Surgery. A Monocentric Prospective Observational Cohort Study

Conditions
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Heart Diseases

Intervention / Treatment
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* Device: Accelerometer


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult subject (≥ 60 years) awaiting elective cardiac surgery Patients affiliated or entitled to a social security scheme Patients who have received information about the study and have given their oral consent to participate Exclusion Criteria: Pregnant woman, Major limitations in physical activity for orthopedic or musculoskeletal reasons Patients under judicial protection (curator or guardianship)

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| complicated post-operative evolution<br>Patients with a postoperative intensive care unity length of stay ≥ 5 days after elective cardiac surgery. They will have an accelerometer. | Device: Accelerometer<br>* Patient will wear the accelerometer for 7 consecutive days to measure the level of physical activity.<br>|
| simple post-operative evolution<br>Patients with a postoperative intensive care unity length of stay < 5 days after elective cardiac surgery. They will have an accelerometer. | Device: Accelerometer<br>* Patient will wear the accelerometer for 7 consecutive days to measure the level of physical activity.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean daily preoperative walking activity (average of steps/day over a period of 7 days) | Measured by accelerometry. | Day: 7 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total energy expenditure evaluated over a 7 days (steps/day) | Measured by accelerometry. | Day: 7 | 
| Low activity time in hours per week (hours/week) | Measured by accelerometry. | Day: 7 | 
| Moderate activity time in hours per week (hours/week) | Measured by accelerometry. | Day: 7 | 
| Intense activity time in hours per week (hours/week) | Measured by accelerometry. | Day: 7 | 
| Time of very intense activity in hours per week (hours/week) | Measured by accelerometry. | Day: 7 | 
| Sleep time in hours per week (hours/week) | Measured by accelerometry. | Day: 7 | 
| Analysis of questionary Duke Activity Status Index (DASI) over a period of 7 days | Questionary Duke Activity Status Index (DASI) estimates the maximum volume of oxygen used in one minute (VO2 Max) as well as its effort capacity in metabolic equivalent. It contains 11 items. The higher the score indicates better functional capacity. | Day: 7 | 
| Analysis of questionary Short Nutritional Assessment Questionnaire (SNAQ) over a period of 7 days | Questionary Short Nutritional Assessment Questionnaire (SNAQ) evaluates nutritional status. The higher the score indicates an important nutritional support. | Day: 7 | 
| Dosage of albumin (g/L) | Measured by blood sample. | Day: 7 | 
| Dosage of prealbumin (g/L) | Measured by blood sample. | Day: 7 | 
| Preoperative strength assessed by dynamometry (Kg) | Measured by Hand Grip test. | Day: 14 | 
| Relationship between preoperative physical activity and duration of stay in intensive care | Correlation between preoperative physical activity and duration of stay in intensive care. | Months: 26 | 
| Preoperative clinical outcome and duration of stay in intensive care | Correlation between preoperative clinical outcome and duration of stay in intensive care. | Months: 26 | 
| Postoperative clinical outcome and duration of stay in intensive care | Correlation between postoperative clinical outcome and duration of stay in intensive care. | Months: 26 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Preoperative physical activity, Post-operative evolution, Accelerometer, Cardiac surgery, Accelerometry