Perioperative Endothelial Dysfunction in Patients Undergoing Major Acute Abdominal Surgery (POETRYabd)
Perioperative Endothelial Dysfunction in Patients Undergoing Major Acute Abdominal Surgery. The POETRY Abdominal Study
The aim of the clinical study is:
- to examine the association between postoperative endothelial function, indirectly measured by reactive hyperemia index, and major adverse cardiovascular events including myocardial injury and cardiac death within 30, 90 and 365 days of acute abdominal surgery.
- to examine the association between postoperative endothelial function, indirectly measured by reactive hyperemia index, and non-cardiovascular complications including non-cardiac death within 30, 90 and 365 days of acute abdominal surgery.
- to examine the importance of the postoperative blood glucose level and the pulmonary function for postoperative complications and death within 30, 90 and 365 days of acute abdominal surgery.
- to examine the association between postoperative endothelial function, pulmonary function and blood glucose level
- the qualitative part of the study will examine the postoperative subjective symptoms including acute and chronic pain, quality of recovery and functional status, depressive thoughts and post-traumatic stress disorder.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
-
-
-
Køge, Denmark, 4600
- Department of Surgery, Zealand University Hospital, Koge
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion criteria
- ≥ 18 years old
- Surgery within 72 hours of an acute admission to the Department of Surgery or an acute reoperation.
- Major gastrointestinal surgery on the gastrointestinal tract. This will include
- Open, laparoscopic, or laparoscopically-assisted procedures
- Procedures involving the stomach, small or large bowel, or rectum for conditions such as perforation, ischaemia, abdominal abscess, bleeding or obstruction
- Washout/evacuation of intra-peritoneal abscess (unless due to appendicitis or cholecystitis - excluded, see below)
- Washout/evacuation of intra-peritoneal hematoma
- Bowel resection/repair due to incarcerated umbilical, inguinal and femoral hernias (but not hernia repair without bowel resection/repair)
- Bowel resection/repair due to obstructing/incarcerated incisional hernias provided the presentation and findings were acute
- Laparotomy/laparoscopy with inoperable pathology (e.g. peritoneal/hepatic metastases)
- Laparoscopic/Open Adhesiolysis
- Return to theatre for repair of fascial dehiscence
- Any reoperation/return to theatre meeting the criteria above is included
If multiple procedures (primary surgery or reoperation) are performed on different anatomical sites within the abdominal/pelvic cavity, the patient would be included if the major procedure is general surgical.
Exclusion criteria
- Not capable of giving informed consent after oral and written information
- Previously included in the trial
- If transferred directly from the operation room or recovery ward to the intensive care unit
- Elective laparoscopy
- Diagnostic laparotomy/laparoscopy where no subsequent procedure is performed (NB, if no procedure is performed because of inoperable pathology, then include)
- Appendectomy +/- drainage of localized collection unless the procedure is incidental to a non-elective procedure on the GI tract
- Cholecystectomy +/- drainage of localized collection unless the procedure is incidental to a non-elective procedure on the GI tract (All surgery involving the appendix or gallbladder, including any surgery relating to complications such as abscess or bile leak is excluded)
- Non-elective hernia repair without bowel resection.
- Minor abdominal wound dehiscence unless this causes bowel complications requiring resection
- Ruptured ectopic pregnancy, or pelvic abscesses due to pelvic inflammatory disease
- Laparotomy/laparoscopy for pathology caused by blunt or penetrating trauma
- Laparotomy/laparoscopy for esophageal pathology Laparotomy/laparoscopy for pathology of the spleen, renal tract, kidneys, liver, gall bladder and biliary tree, pancreas or urinary tract
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
The change in reactive hyperemia index assessed by EndoPat
Time Frame: The change from 4-24 hours to between day 3 and 5 after surgery
|
The change from 4-24 hours to between day 3 and 5 after surgery
|
|
|
Major adverse cardiovascular events
Time Frame: Within 365 days of surgery
|
|
Within 365 days of surgery
|
|
Postoperative non-cardiovascular complications
Time Frame: Within 365 days of surgery
|
Non-cardiovascular death, sepsis, pneumonia, respiratory failure, surgical complications (min.
Clavien-Dindo stage 3), Any non-cardiovascular life-threatening complication (Clavien-Dindo stage 4).
|
Within 365 days of surgery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Nitric oxide biomarkers
Time Frame: 4-24 hours after surgery and between postoperative day 3-5
|
4-24 hours after surgery and between postoperative day 3-5
|
|
Reactive hyperemia index assessed by EndoPat
Time Frame: 4-24 hours after surgery
|
4-24 hours after surgery
|
|
Reactive hyperemia index assessed by EndoPat
Time Frame: between day 3 and 5 after surgery
|
between day 3 and 5 after surgery
|
|
Blood Glucose level
Time Frame: Postoperative day 1 - 7 (or until discharge)
|
Postoperative day 1 - 7 (or until discharge)
|
|
Pulmonary function
Time Frame: Postoperative day 1 - 7 (or until discharge)
|
Postoperative day 1 - 7 (or until discharge)
|
|
Readmission
Time Frame: Readmissions within 1 year of discharge
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Readmissions within 1 year of discharge
|
|
Lengths of stay
Time Frame: Lengths of stay from the operation day to discharge, on average 14 days.
|
Lengths of stay from the operation day to discharge, on average 14 days.
|
|
Lengths of stay in the intensive care unit
Time Frame: Lengths of stay from the operation day to discharge from hospital, on average 14 days.
|
Lengths of stay from the operation day to discharge from hospital, on average 14 days.
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Postoperative quality of recovery (QoR15)
Time Frame: postoperative day 1, 3, 5, 7, 14, 30, 90 and 365
|
QoR15 score
|
postoperative day 1, 3, 5, 7, 14, 30, 90 and 365
|
|
Numerical rating scale (NRS) pain score
Time Frame: postoperative day 1, 3, 5, 7, 14, 30, 90 and 365
|
NRS pain score in rest and at activity
|
postoperative day 1, 3, 5, 7, 14, 30, 90 and 365
|
|
Post-Traumatic Stress Disorder
Time Frame: postoperative day 14, 30, 90 and 365
|
Post-Traumatic Stress Disorder questionnaire
|
postoperative day 14, 30, 90 and 365
|
|
Depressive thoughts
Time Frame: postoperative day 14, 30, 90 and 365
|
Hospital anxiety and depression scale
|
postoperative day 14, 30, 90 and 365
|
|
Postoperative pain
Time Frame: postoperative day 14, 30, 90 and 365
|
Questionnaire Self-reported Leeds Assessment of Neuropatic Symptoms and Signs pain scale (S-LANSS)
|
postoperative day 14, 30, 90 and 365
|
|
Functional status
Time Frame: postoperative day 14, 30, 90 and 365
|
Activity Assessment Scale
|
postoperative day 14, 30, 90 and 365
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Sarah Ekeloef, MD, Department of Surgery, Zealand University Hospital
- Principal Investigator: Jakob Burcharth, MD, Phd., Department of Surgery, Zealand University Hospital
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- POETRY abdominal
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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