- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT04878159
Troponin T and Emergency High-risk Abdominal Surgery
Association of Cardiac and Inflammatory Bio Markers and Morbidity in Emergency High-risk Abdominal Surgery
Studieoversikt
Status
Detaljert beskrivelse
Cardiac Troponin T (TnT) is a cardiac-specific molecule, released into the systemic circulation following myocardial cell injury. The release of cardiac Troponins is common during critical illness and is associated with increased morbidity and mortality. The mechanisms by which TnT is released in the blood during critical illness are not fully understood, but sepsis and inflammation are primary non-cardiac conditions during which elevated TnT levels are commonly seen. Previous research has shown that 84 percent of patients admitted to ICU had at least one elevated TnT measurement perioperatively. Patients undergoing high-risk abdominal surgery, defined as immediate emergency laparoscopy or laparotomy, are critically ill, often septic and with an acute inflammatory response and potential multiple organ system dysfunctions both prior but largely after surgery.
The hypothesis is that there is an association between elevated perioperative levels of cardiac Troponin T and mortality in patients undergoing emergency high-risk abdominal surgery.
The primary objective is to assess whether perioperatively elevated TnT levels, using high sensitivity troponin T (hsTnT) measurements, are associated with an increased risk of postoperative mortality as well as severe postoperative complications.
Patients requiring immediate emergency laparotomy or laparoscopy, including reoperations after elective gastrointestinal surgery and reoperations after previous non emergency high-risk abdominal surgery surgery, will be included in the study.
Two primary exposure measures will be investigated:
- Peak Troponin T values ≥14 vs. Troponin T values <14. Patients with at least one measured Troponin T value ≥14 postoperatively will be allocated to the "elevated hsTnT" group
- Postoperative hsTnT concentration ≥14 as well as a >50% relative increase from preoperative hsTnT concentration. Patients with hsTnT levels meeting these conditions will be allocated to the "elevated hsTnT" group hsTnT will be taken by blood samples preoperatively as well as on postoperative day 1, 2 and 3.
Primary analyses investigating the association between hsTnT and 30-day mortality (yes/no) and severe complications (yes/no) will be done using logistic regression models.
Studietype
Registrering (Forventet)
Kontakter og plasseringer
Studiekontakt
- Navn: Sofia Kärnsund
- Telefonnummer: +4528261925
- E-post: sofia.paulina.kaernsund@regionh.dk
Studiesteder
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Hvidovre, Danmark
- Rekruttering
- Copenhagen University Hospital Hvidovre
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Ta kontakt med:
- Sofia Kärnsund, Medical Student
- Telefonnummer: +4528261925
- E-post: sofia.paulina.kaernsund@regionh.dk
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Ta kontakt med:
- Mirjana Cihoric, MD
- E-post: mirjana.cihoric.03@regionh.dk
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Prøvetakingsmetode
Studiepopulasjon
Beskrivelse
Inclusion Criteria:
Adults (18 years or over) undergoing emergency laparotomy or laparoscopy for following abdominal pathology:
- Intestinal obstruction
- Perforated viscus
- Intestinal ischemia
- Intraabdominal bleeding
The above conditions include both primary surgery and re-operation after elective surgery.
Exclusion Criteria:
Patients undergoing
- Appendicectomies
- Negative laparoscopies/laparotomies
- Cholecystectomies
- Simple herniotomies following incarceration without bowel resection
- Reoperation due to fascial separation with no other abdominal pathology identified
- Internal hernia after Roux-en-Y gastric bypass surgery
- Subacute surgery (surgery planned within 48 h) for inflammatory bowel diseases
- Subacute colorectal cancer surgery
- Patients with missing hsTnT values on both postoperative day 1 and 2
Studieplan
Hvordan er studiet utformet?
Designdetaljer
Kohorter og intervensjoner
Gruppe / Kohort |
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Emergency high-risk abdominal surgery
Patients undergoing emergency high-risk abdominal surgery, defined as immediate emergency laparoscopy or laparotomy, including intestinal obstruction, perforated viscus, intestinal ischemia and intraabdominal bleeding.
Includes both primary surgery and re-operation after elective surgery.
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tidsramme |
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Død
Tidsramme: 30 dager
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30 dager
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Severe complication (Clavien Dindo ≥ 3)
Tidsramme: 30 days
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30 days
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Sekundære resultatmål
Resultatmål |
Tidsramme |
---|---|
Lengde på sykehusopphold
Tidsramme: 30 dager
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30 dager
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Død
Tidsramme: 90 dager
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90 dager
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Lengde på intensivavdelingen
Tidsramme: 30 dager
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30 dager
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Samarbeidspartnere og etterforskere
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Primær fullføring (Forventet)
Studiet fullført (Forventet)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- H-21012302
Plan for individuelle deltakerdata (IPD)
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