PeriOP-CARE HF

The PeriOP-CARE HF study, short for "Perioperative, interdisciplinary, intersectoral process optimisation in heart failure: a multicentre, prospective randomised controlled intervention study", aims to reduce complications following non-cardiac surgery in patients over 65 years of age with an increased risk of heart failure. Herefor, a multimodal, interdisciplinary and intersectoral treatment concept will be evaluated.

For this purpose, patients will be randomly assigned to the control or intervention group after enrollment and detection of an elevated NT-proBNP level (>= 450pg/ml). The latter is associated with an increased risk of complications following planned surgeries.

The control group will be treated with standard care according to current guidelines. In the intervention group, a comprehensive preoperative anamnesis (including resting ECG, echo) is performed, the results of which are discussed in an interdisciplinary and intersectoral conference. This conference decides whether to process with, optimize, or cancel the planned surgery. Intraoperatively, patients of the intervention group receive more comprehensive monitoring than patients in the control group, who are treated with standard care. Until the day of discharge, patients in the intervention group will receive a daily structured heart failure monitoring and at least one interdisciplinary round.

After discharge, all patients are followed up for up to 90 days. This includes a telephone visit after 30 days and an on-site visit after 90 days. In addition to clinical measures, anxiety, depression and quality of life will be assessed using validated instruments before surgery and at the two follow-up visits in both study groups.