# Evaluation of Wearables for Preoperative Cardiorespiratory Fitness Screening and Risk Stratification in Geriatric Surgery

> **NIH NIH R03** · WEILL MEDICAL COLL OF CORNELL UNIV · 2022 · $169,500

## Abstract

PROJECT SUMMARY
Major surgeries are becoming increasingly common in older adults with approximately half of the population
over the age of 65 years requiring surgery at least once during the remainder of their lives. This trend is highly
concerning for public health, because older adults are well known to suffer high rates of postoperative
morbidity and mortality following major surgeries due to diminished functional capacity, comorbidities, frailty,
and lack of access to comprehensive geriatric care. Preoperative risk stratification is of particular importance in
geriatric surgery to identify patients at increased risk of surgical complications, to fully inform patients and
providers in their surgical decision-making, and to determine if additional preoperative testing or medical
interventions are required prior to surgery. Functional capacity as measured by maximum oxygen uptake
(VO2peak), is an important factor in older adults presenting for major surgery, because it is highly correlated to
postoperative morbidity and mortality, provides a holistic picture of cardiorespiratory fitness, and is modifiable
with prehabilitation exercise programs. Although direct measurement of maximum oxygen uptake is possible
with sophisticated cardiopulmonary exercise testing (CPET), wide-scale implementation of this measurement is
not practical due to the need for specialized equipment, trained personnel, and financial and logistical
challenges. Wearable fitness monitors capable of remote mobility and physiology monitoring offer an
alternative to direct cardiopulmonary exercise measurement through indirect prediction of functional capacity
using cardiorespiratory fitness metrics, such as exercise intensity and heart rate reserve. The proposed
research aims to: (1) assess the accuracy of wearable devices for predicting VO2peak in older adults; and (2)
evaluate the odds of perioperative complications using wearable-predicted VO2peak in older adults undergoing
major noncardiac surgery. A prospective observational clinical study will be conducted to measure preoperative
wearable fitness monitor data and gold-standard CPET-measured VO2peak in older adults scheduled for major
surgery at Weill Cornell Medical College. This project will be the first to use wearable fitness monitors for
preoperative cardiorespiratory fitness screening and risk stratification in older adults, and will set the stage for
future studies of wearable protocols for surgical risk stratification in older adults and wearable-guided
prehabilitation interventions. The contribution will be significant because it is expected to improve preoperative
screening in vulnerable older adults scheduled for major surgery with practical, cost effective and accessible
consumer health technology.

## Key facts

- **NIH application ID:** 10450122
- **Project number:** 5R03AG074070-02
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** Richard Boyer
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $169,500
- **Award type:** 5
- **Project period:** 2021-07-15 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10450122

## Citation

> US National Institutes of Health, RePORTER application 10450122, Evaluation of Wearables for Preoperative Cardiorespiratory Fitness Screening and Risk Stratification in Geriatric Surgery (5R03AG074070-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10450122. Licensed CC0.

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