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Vascular Events In Patients Undergoing Same-day Noncardiac Surgery (VALIANCE) Study

Recruiting
Conditions
Surgery--Complications
Preoperative Care
Myocardial Infarction
Registration Number
NCT04973397
Lead Sponsor
Centre hospitalier de l'Université de Montréal (CHUM)
Brief Summary

The proportion of noncardiac surgeries performed as same-day surgery is increasing worldwide, with more complex surgeries being performed on higher risk patients in the outpatient setting. Little is known on the risk factors, incidence and prognosis of patients undergoing same-day noncardiac surgery. The main objective of this study is to inform on the incidence and risk factors of cardiovascular and other adverse events after same-day surgery and to develop risk prediction tools to better inform on the risk and selection of patients undergoing same-day surgery.

Detailed Description

The VALIANCE Study is a 15,000 patient, multicentre, prospective observational cohort of adults undergoing elective same-day noncardiac surgery and who will be followed for 90 days after surgery. The primary objective of the study is to determine the incidence of major cardiovascular complications after same-day surgery. Patients will also be followed for the occurence of other adverse postoperative complications and determine their change in quality of life at 90 days after surgery. VALIANCE will inform on the risk factors for postoperative complications and allow to develop risk prediction tools to guide patient selection and risk stratification of patients undergoing same-day surgery. The study will also look at validating the use of the Duke Activity Status Index questionnaire, Clinical Frailty Scale, and the Revised Cardiac Risk Index. Postoperative pain will be evaluated using the Brief pain inventory score and quality of life using the EQ-5D-5L questionnaire.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
15000
Inclusion Criteria
  • 45-64 years of age with at least one risk factor, or ≥65 years of age;
  • undergoing elective noncardiac same-day surgery;
  • planned duration in the operating room 60 minutes or more;
  • provided written consent.
Exclusion Criteria
  • intervention does not require the presence of an anesthesiologist;
  • procedure is performed by a nonsurgical specialty (e.g., gastroenterology, pneumology, radio-oncology or radiology);
  • intervention is an ophthalmologic procedure;
  • previously enrolled in the VALIANCE study.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Unplanned healthcare utilization90 days

the number of patients who have at least one of the following: unplanned admission after surgery, unplanned outpatient visit, emergency room visit and rehospitalization after same-day surgery

Secondary Outcome Measures
NameTimeMethod
stroke90 days

the number of patients who experience a stroke

transient ischemic attack90 days

the number of patients who experience a transient ischemic attack

coronary revascularization90 days

the number of patients who undergo coronary revascularization

unplanned admission90 days

the number of patients who have to be admitted to the hospital after undergoing a surgery planned as same-day

major postoperative and life-threatening bleeding90 days

the number of patients who experience a major postoperative and/or life-threatening bleeding

re-hospitalization90 days

the number of patients who have to be readmitted to the hospital after being discharged home following their same-day surgery

myocardial injury after noncardiac surgery (MINS)90 days

the number of patients who experience a MINS

non-fatal cardiac arrest90 days

the number of patients who experience a non-fatal cardiac arrest

unplanned outpatient visit90 days

the number of patient who had a medical visit in an outpatient setting after undergoing same-day surgery

emergency room visit90 days

the number of patients who visited the emergency room without subsequent hospitalization after undergoing same-day surgery

major cardiovascular complications90 days

the number of patients who have at least one of the following: myocardial injury or infarction, non-fatal cardiac arrest, coronary revascularization, stroke, transient ischemic attack, new clinically significant arrythmia, congestive heart failure, unplanned postoperative admission for vascular reasons, emergency room visit for vascular reasons, rehospitalization for vascular reasons, and all-cause mortality

myocardial infarction90 days

the number of patients who experience a myocardial infarction

new clinically important arrythmia90 days

the number of patients who experience a new clinically important arrythmia

deep vein thrombosis90 days

the number of patients who experience a deep vein thrombosis

pulmonary embolism90 days

the number of patients who experience a pulmonary embolism

acute congestive heart failure90 days

the number of patients who experience an acute congestive heart failure episode

postoperative infection90 days

the number of patients who experience a postoperative infection

quality of life score on the 5-level EQ-5D version (EQ-5D-5L) questionnaire90 days

score on the EQ-5D-5L questionnaire on 4 health profiles (level 1 to 5), overall self-rated health status (0-100 visual analogue scale), and EQ-5D-5L index value (0.01-0.99)

functional capacity score on the Duke Activity Status Index (DASI)90 days

change in the score on the Duke Activity Status Index (DASI) questionnaire (0 to 58.2 points)

frailty90 days

change in the level on the Clinical Frailty Scale (level 1 to 9)

acute kidney injury90 days

the number of patients who experience a acute kidney injury

Trial Locations

Locations (14)

St-Micheal's Hospital

🇨🇦

Toronto, Ontario, Canada

Wake Forest Baptist Medical Centre

🇺🇸

Winston-Salem, North Carolina, United States

Cleveland Clinic Foundation Fairview Campus

🇺🇸

Cleveland, Ohio, United States

Cleveland Clinic Foundation Main Campus

🇺🇸

Cleveland, Ohio, United States

St-Joseph's Healthcare Hamilton

🇨🇦

Hamilton, Ontario, Canada

Hamilton General Hospital

🇨🇦

Hamilton, Ontario, Canada

Juravinski Hospital and Cancer Centre

🇨🇦

Hamilton, Ontario, Canada

McMaster University Medical Centre

🇨🇦

Hamilton, Ontario, Canada

Mount Sinai Hospital

🇨🇦

Toronto, Ontario, Canada

Toronto Western Hospital

🇨🇦

Toronto, Ontario, Canada

Centre Hospitalier de l'Université de Montréal (CHUM)

🇨🇦

Montreal, Quebec, Canada

Centre Hospitalier Universitaire de Sherbrooke

🇨🇦

Sherbrooke, Quebec, Canada

Maasstad Ziekenhuis Rotterdam

🇳🇱

Rotterdam, Netherlands

Hospital Clinic Barcelona

🇪🇸

Barcelona, Spain

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