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Patients with heart failure NYHA >= II receiving non-emergent non-cardiac in-patient surgery will be randomized to receive either standard post-operative care (surgeon has to ask actively for specialist cardiological support) or a nurse-based heart failure management (nurses provide week-day support every day after surgery, if needed together with a heart failure doctor)
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| standard care | Other | responsible surgeon has actively to ask for cardiology support (he decides whether a heart failure specialist should see the patient post-operatively) |
|
| nurse-based care | Other | heart failure nurses visit postoperatively every (working-) day to check fluid balance, medication, rhythm and general condition |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| standard care | Other | cardiologists assist in treatment and provide heart failure guidance post-operatively if required by the treating surgeon |
|
| Measure | Description | Time Frame |
|---|---|---|
| composite endpoint of in-hospital heart failure-related complications (readmission on ICU, re-initiation of inotropic support, pleural effusion, pulmonary edema, pneumonia requiring antibiotic treatment, non-invasive or invasive ventilation) | severe heart-failure related clinical events during hospitalisation for non-cardiac surgery | 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| days in hospital | total days in hospital for non-cardiac surgery | 90 days |
| acute kidney injury | Acute kidney injury grade: 0 = Creatinine increase < 1,5 x baseline, Stage 1 Creatinine increase > 1,5 x baseline, Stage 2 Creatinine increase > 2 x baseline, Stage 3 Creatinine increase > 3 x baseline) |
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Inclusion Criteria:
patients with heart failure NYHA >= II (HFrEF and HFpEF) or LVEF <= 40% non-cardiac surgery planned later than 24 hours age > 18 years written informed consent
Exclusion Criteria:
patients on intensive care life-expectancy < 3 months
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Birgit Assmus, MD | Contact | +49696301 | 5789 | birgit.assmus@kgu.de |
| Andreas M Zeiher, MD | Contact | +49696301 | 84690 | zeiher@em.uni-frankfurt.de |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Goethe University Hospital | Enrolling by invitation | Frankfurt am Main | Hesse | 60590 | Germany | |
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| ID | Term |
|---|---|
| D006333 | Heart Failure |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D059039 | Standard of Care |
| ID | Term |
|---|---|
| D019984 | Quality Indicators, Health Care |
| D011787 | Quality of Health Care |
| D006298 | Health Services Administration |
| D017530 | Health Care Quality, Access, and Evaluation |
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| Nurse-based care | Other | board-certified heart failure nurses provide heart failure guidance post-operatively on every working day |
|
| 90 days |
| Qulity of Life by SF-12 | repetitive assessment with SF-12 | 90 days |
| Klinikum Goethe University |
| Recruiting |
| Frankfurt am Main |
| 60590 |
| Germany |
|