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- Sperimentazione clinica NCT07638917
BBCMADE Nomogram Validation for High-Risk Gastric Content in Sedative Endoscopy (BBCMADE)
Prospective Validation of the BBCMADE Nomogram for Predicting High-Risk Gastric Content in Patients Undergoing Elective Sedative Gastrointestinal Endoscopy
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
Pulmonary aspiration of gastric contents accounts for 10-30% of anesthesia-related deaths. Standard fasting guidelines do not guarantee adequate gastric emptying in all patients. The BBCMADE nomogram, developed and validated by Yan et al. (2024) in a Chinese population, demonstrated high discriminatory power for predicting high-risk gastric residual content in outpatients undergoing sedative GI endoscopy. This study will prospectively evaluate its validity in a Turkish population (n=533).
The seven predictor variables (BMI, history of cerebral infarction, cirrhosis, male sex, age, diabetes, gastroesophageal reflux) will be recorded preoperatively and entered into the web-based nomogram interface. Endoscopic gastric volume measurement will serve as the gold standard. Discriminatory performance will be assessed by AUROC. Secondary analyses will include sensitivity, specificity, PPV, NPV, and subgroup analyses.
Sample size: 533 patients (prevalence ~13%, α=0.05, power=95%, 15% dropout allowance; calculated using G*Power 3).
Tipo di studio
Iscrizione (Effettivo)
Contatti e Sedi
Luoghi di studio
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Bursa, Turchia (Türkiye)
- Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Türkiye
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Metodo di campionamento
Popolazione di studio
Descrizione
Inclusion Criteria:
- Age 18 years or older
- ASA physical status I-III
- Scheduled for elective gastrointestinal endoscopy under sedoanalgesia
- Deemed suitable for out-of-OR anesthesia by the anesthesiology outpatient clinic
- Provision of written informed consent
Exclusion Criteria:
- Age under 18 years
- Pregnancy or suspected pregnancy
- ASA physical status IV or higher
- Emergency procedures
- Unable or unwilling to provide informed consent
- History of upper airway obstructive pathology or difficult airway
- Not eligible for out-of-OR anesthesia
- Known hypersensitivity to anesthetic agents
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
Coorti e interventi
Gruppo / Coorte |
Intervento / Trattamento |
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Study Cohort
Patients scheduled for elective sedative gastrointestinal endoscopy.
Gastric volume and pH were measured endoscopically during the procedure.
Patients were classified as high or low aspiration risk based on endoscopic measurements.
The BBCMADE nomogram score was calculated for each patient and compared against the endoscopic findings to validate its predictive accuracy.
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The BBCMADE nomogram (Body Mass Index, Brain infarction, Cirrhosis, Male sex, Age, Diabetes, Esophageal reflux) is applied to predict high-risk gastric content prior to elective sedative gastrointestinal endoscopy.
Nomogram scores are compared against the gold standard endoscopic measurement of gastric volume and pH to prospectively validate the model in a Turkish population.
Gold-standard assessment of gastric contents is performed during endoscopy.
Gastric volume ≥25 mL, pH <2.5, or the presence of solid content is defined as high risk for pulmonary aspiration.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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Discriminatory Performance of the BBCMADE Nomogram
Lasso di tempo: At time of procedure
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Area under the receiver operating characteristic curve (AUROC) of the BBCMADE nomogram for predicting high-risk gastric content, defined as gastric volume ≥25 mL, pH <2.5, or presence of solid content, as confirmed by endoscopic measurement.
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At time of procedure
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Collaboratori e investigatori
Sponsor
Investigatori
- Investigatore principale: Füsun Gözen, SBÜ Bursa Yüksek İhtisas Training and Research Hospital
Pubblicazioni e link utili
Pubblicazioni generali
- Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017 Mar;126(3):376-393. doi: 10.1097/ALN.0000000000001452. No abstract available.
- Yan Y, Jin Y, Cao Y, Chen C, Zhao X, Xia H, Yan L, Si Y, Zou J. Development and validation of a novel nomogram model to assess the risk of gastric contents in outpatients undergoing elective sedative gastrointestinal endoscopy procedures. Clin Res Hepatol Gastroenterol. 2024 Feb;48(2):102277. doi: 10.1016/j.clinre.2023.102277. Epub 2023 Dec 28.
- Phillips S, Liang SS, Formaz-Preston A, Stewart PA. High-risk residual gastric content in fasted patients undergoing gastrointestinal endoscopy: a prospective cohort study of prevalence and predictors. Anaesth Intensive Care. 2015 Nov;43(6):728-33. doi: 10.1177/0310057X1504300610.
- Friedrich K, Scholl SG, Beck S, Gotthardt D, Stremmel W, Rex DK; bng-Study-Group; Sieg A. Respiratory complications in outpatient endoscopy with endoscopist-directed sedation. J Gastrointestin Liver Dis. 2014 Sep;23(3):255-9. doi: 10.15403/jgld.2014.1121.233.kf1.
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Altri numeri di identificazione dello studio
- 2024-TBEK 2025/10-09
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