This single-center prospective cohort study is designed to evaluate whether preoperative physical activity measured by a wearable accelerometer is associated with cardiovascular autonomic function and whether it can help predict post-induction hypotension in elderly patients undergoing elective non-cardiac surgery. Patients aged 65 years or older scheduled for general anesthesia with tracheal intubation will undergo preoperative physical activity monitoring using an ActiGraph wearable accelerometer. Activity-related parameters, including sedentary time, light-, moderate-, and vigorous-intensity activity, daily step count, and sleep duration, will be recorded. Cardiovascular autonomic function will be assessed perioperatively using noninvasive continuous hemodynamic monitoring, with baroreflex sensitivity-related indices derived from continuous blood pressure and beat-to-beat timing data. The primary outcome is post-induction hypotension. Secondary outcomes include early intraoperative hypotension, postoperative complications, and 30-day mortality. This study aims to clarify the relationship between habitual physical activity and autonomic regulation in older surgical patients and to provide evidence supporting future prehabilitation strategies.
Age ≥65 years
Scheduled for elective non-cardiac surgery
American Society of Anesthesiologists (ASA) physical status I-III
Planned to undergo general anesthesia
Severe vascular disease
Secondary hypertension
Limb tremor disorders, such as Parkinson disease
Inability to wear a wrist-based wearable accelerometer for any reason
Elderly patients who will undergo general anesthesia surgery in Peking Union Medical College Hospital.
Cohort
Prospective
Not listed
Post induction hypotension
Systolic blood pressure less than 90 mmHg, mean arterial pressure less than 65 mmHg, or a decrease of more than 30% from baseline.
Early intraoperative hypotension
Systolic blood pressure less than 90 mmHg, mean arterial pressure less than 65 mmHg, or a decrease of more than 30% from baseline.
Postoperative complications
We use Clavien-Dindo system to grade postoperative complications
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