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.
Visão geral do estudo
Status
Status
Condições
Condições
Intervenção / Tratamento
Intervenção / Tratamento
Tipo de estudo
Tipo de estudo
Inscrição (Real)
Inscrição
Contactos e Locais
Locais de estudo
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-
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Køge, Dinamarca, 4600
- Department of Surgery, Zealand University Hospital, Koge
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-
Critérios de participação
Critérios de elegibilidade
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Método de amostragem
População do estudo
Descrição
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
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
O que o estudo está medindo?
Medidas de resultados primários
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
The change in reactive hyperemia index assessed by EndoPat
Prazo: 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
Prazo: Within 365 days of surgery
|
|
Within 365 days of surgery
|
|
Postoperative non-cardiovascular complications
Prazo: 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
|
Medidas de resultados secundários
Medidas de resultados secundários
Medida de resultado |
Prazo |
|---|---|
|
Nitric oxide biomarkers
Prazo: 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
Prazo: 4-24 hours after surgery
|
4-24 hours after surgery
|
|
Reactive hyperemia index assessed by EndoPat
Prazo: between day 3 and 5 after surgery
|
between day 3 and 5 after surgery
|
|
Blood Glucose level
Prazo: Postoperative day 1 - 7 (or until discharge)
|
Postoperative day 1 - 7 (or until discharge)
|
|
Pulmonary function
Prazo: Postoperative day 1 - 7 (or until discharge)
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Postoperative day 1 - 7 (or until discharge)
|
|
Readmission
Prazo: Readmissions within 1 year of discharge
|
Readmissions within 1 year of discharge
|
|
Lengths of stay
Prazo: 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
Prazo: 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.
|
Outras medidas de resultado
Outras medidas de resultado
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Postoperative quality of recovery (QoR15)
Prazo: 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
|
|
Numerical rating scale (NRS) pain score
Prazo: 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
|
|
Post-Traumatic Stress Disorder
Prazo: postoperative day 14, 30, 90 and 365
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Post-Traumatic Stress Disorder questionnaire
|
postoperative day 14, 30, 90 and 365
|
|
Depressive thoughts
Prazo: postoperative day 14, 30, 90 and 365
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Hospital anxiety and depression scale
|
postoperative day 14, 30, 90 and 365
|
|
Postoperative pain
Prazo: 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
Prazo: postoperative day 14, 30, 90 and 365
|
Activity Assessment Scale
|
postoperative day 14, 30, 90 and 365
|
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
Publicações e links úteis
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo
Início do estudo
Conclusão Primária (Real)
Conclusão Primária
Conclusão do estudo (Real)
Conclusão do estudo
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Primeira postagem
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última Atualização Postada
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
Outros números de identificação do estudo
- POETRY abdominal
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Descrição do plano IPD
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