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.
Aperçu de l'étude
Statut
Statut
Les conditions
Les conditions
Intervention / Traitement
Intervention / Traitement
Type d'étude
Type d'étude
Inscription (Réel)
Inscription
Contacts et emplacements
Lieux d'étude
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-
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Køge, Danemark, 4600
- Department of Surgery, Zealand University Hospital, Koge
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Critères de participation
Critère d'éligibilité
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
La 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
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
Que mesure l'étude ?
Principaux critères de jugement
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
The change in reactive hyperemia index assessed by EndoPat
Délai: 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
Délai: Within 365 days of surgery
|
|
Within 365 days of surgery
|
|
Postoperative non-cardiovascular complications
Délai: Within 365 days of surgery
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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
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Mesures de résultats secondaires
Mesures de résultats secondaires
Mesure des résultats |
Délai |
|---|---|
|
Nitric oxide biomarkers
Délai: 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
Délai: 4-24 hours after surgery
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4-24 hours after surgery
|
|
Reactive hyperemia index assessed by EndoPat
Délai: 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
Délai: Postoperative day 1 - 7 (or until discharge)
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Postoperative day 1 - 7 (or until discharge)
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|
Pulmonary function
Délai: Postoperative day 1 - 7 (or until discharge)
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Postoperative day 1 - 7 (or until discharge)
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Readmission
Délai: Readmissions within 1 year of discharge
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Readmissions within 1 year of discharge
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|
Lengths of stay
Délai: 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
Délai: 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.
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Autres mesures de résultats
Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Postoperative quality of recovery (QoR15)
Délai: 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
Délai: 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
Délai: postoperative day 14, 30, 90 and 365
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Post-Traumatic Stress Disorder questionnaire
|
postoperative day 14, 30, 90 and 365
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|
Depressive thoughts
Délai: 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
Délai: 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
Délai: 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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Collaborateurs et enquêteurs
Parrainer
Parrainer
Les enquêteurs
Les enquêteurs
- Chercheur principal: Sarah Ekeloef, MD, Department of Surgery, Zealand University Hospital
- Chercheur principal: Jakob Burcharth, MD, Phd., Department of Surgery, Zealand University Hospital
Publications et liens utiles
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement primaire
Achèvement de l'étude (Réel)
Achèvement de l'étude
Dates d'inscription aux études
Première soumission
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Première publication
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour publiée
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
Autres numéros d'identification d'étude
- POETRY abdominal
Plan pour les données individuelles des participants (IPD)
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Description du régime IPD
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