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.
Descripción general del estudio
Estado
Estado
Condiciones
Condiciones
Intervención / Tratamiento
Intervención / Tratamiento
Tipo de estudio
Tipo de estudio
Inscripción (Actual)
Inscripción
Contactos y Ubicaciones
Ubicaciones de estudio
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Køge, Dinamarca, 4600
- Department of Surgery, Zealand University Hospital, Koge
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Criterios de participación
Criterio de elegibilidad
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Método de muestreo
Población de estudio
Descripción
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
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
¿Qué mide el estudio?
Medidas de resultado primarias
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
The change in reactive hyperemia index assessed by EndoPat
Periodo de tiempo: The change from 4-24 hours to between day 3 and 5 after surgery
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The change from 4-24 hours to between day 3 and 5 after surgery
|
|
|
Major adverse cardiovascular events
Periodo de tiempo: Within 365 days of surgery
|
|
Within 365 days of surgery
|
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Postoperative non-cardiovascular complications
Periodo de tiempo: 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).
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Within 365 days of surgery
|
Medidas de resultado secundarias
Medidas de resultado secundarias
Medida de resultado |
Periodo de tiempo |
|---|---|
|
Nitric oxide biomarkers
Periodo de tiempo: 4-24 hours after surgery and between postoperative day 3-5
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4-24 hours after surgery and between postoperative day 3-5
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Reactive hyperemia index assessed by EndoPat
Periodo de tiempo: 4-24 hours after surgery
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4-24 hours after surgery
|
|
Reactive hyperemia index assessed by EndoPat
Periodo de tiempo: between day 3 and 5 after surgery
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between day 3 and 5 after surgery
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Blood Glucose level
Periodo de tiempo: Postoperative day 1 - 7 (or until discharge)
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Postoperative day 1 - 7 (or until discharge)
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Pulmonary function
Periodo de tiempo: Postoperative day 1 - 7 (or until discharge)
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Postoperative day 1 - 7 (or until discharge)
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Readmission
Periodo de tiempo: Readmissions within 1 year of discharge
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Readmissions within 1 year of discharge
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|
Lengths of stay
Periodo de tiempo: Lengths of stay from the operation day to discharge, on average 14 days.
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Lengths of stay from the operation day to discharge, on average 14 days.
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Lengths of stay in the intensive care unit
Periodo de tiempo: Lengths of stay from the operation day to discharge from hospital, on average 14 days.
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Lengths of stay from the operation day to discharge from hospital, on average 14 days.
|
Otras medidas de resultado
Otras medidas de resultado
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Postoperative quality of recovery (QoR15)
Periodo de tiempo: postoperative day 1, 3, 5, 7, 14, 30, 90 and 365
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QoR15 score
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postoperative day 1, 3, 5, 7, 14, 30, 90 and 365
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Numerical rating scale (NRS) pain score
Periodo de tiempo: postoperative day 1, 3, 5, 7, 14, 30, 90 and 365
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NRS pain score in rest and at activity
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postoperative day 1, 3, 5, 7, 14, 30, 90 and 365
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|
Post-Traumatic Stress Disorder
Periodo de tiempo: postoperative day 14, 30, 90 and 365
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Post-Traumatic Stress Disorder questionnaire
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postoperative day 14, 30, 90 and 365
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Depressive thoughts
Periodo de tiempo: postoperative day 14, 30, 90 and 365
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Hospital anxiety and depression scale
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postoperative day 14, 30, 90 and 365
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Postoperative pain
Periodo de tiempo: postoperative day 14, 30, 90 and 365
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Questionnaire Self-reported Leeds Assessment of Neuropatic Symptoms and Signs pain scale (S-LANSS)
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postoperative day 14, 30, 90 and 365
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Functional status
Periodo de tiempo: postoperative day 14, 30, 90 and 365
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Activity Assessment Scale
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postoperative day 14, 30, 90 and 365
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Colaboradores e Investigadores
Patrocinador
Patrocinador
Investigadores
Investigadores
- Investigador principal: Sarah Ekeloef, MD, Department of Surgery, Zealand University Hospital
- Investigador principal: Jakob Burcharth, MD, Phd., Department of Surgery, Zealand University Hospital
Publicaciones y enlaces útiles
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Inicio del estudio
Finalización primaria (Actual)
Finalización primaria
Finalización del estudio (Actual)
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Publicado por primera vez
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización publicada
Última actualización enviada que cumplió con los criterios de control de calidad
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
Otros números de identificación del estudio
- POETRY abdominal
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
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