Continuously Iterative Perioperative Holistic Evaluation of Risk and Hypotension Prediction Index
- Conditions
- Surgery--Complications
- Registration Number
- NCT04807036
- Brief Summary
The investigators would like to explore whether Hypotension Prediction Index during and immediately after surgery can be used to improve the accuracy of scores that predict postoperative problems.
- Detailed Description
It is known that some patients have a prolonged and difficult recovery after major surgery, which impacts their long-term health and wellbeing. A major issue is that scores for predicting recovery are typically generated only once in the period before surgery, but subsequent events during and immediately after surgery can also alter the likelihood of a prolonged and difficult recovery.
One such event appears to be low blood pressure (hypotension). Hypotension Prediction Index can be calculated from routine blood pressure measurements, and is an indicator of blood pressure instability. The investigators propose that Hypotension Prediction Index during and immediately after surgery may be used to improve their accuracy of scores that predict postoperative problems.
To explore this, the investigators will collect information about the health and care needs, surgery and postoperative recovery of adult patients' requiring major surgery. This data will be taken from hospital information systems, a bedside monitor, test reports, a questionnaire and National Databases. The investigators will then use statistical models to determine whether Hypotension Prediction Index improves the accuracy of preoperative scores for predicting postoperative problems.
Ultimately, the investigators hope to create a tool for predicting how well a patient will recover based on the information available at any given point in time. Healthcare professionals will be able to use this tool to identify and support the needs of patients who need extra help recovering from major surgery.
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 150
Patients who:
- are referred for CPET
- are scheduled for elective surgery and expected to have >24 hours postoperative hospital stay
- will receive invasive arterial pressure monitoring as part of routine care
- are aged 18 or over
- have the capacity to give consent to participate
Patients who:
- do not proceed to surgery following CPET referral
- are aged less than 18 years
- do not have capacity to consent
- decline to consent
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Days alive and out of hospital Day 30 Number of days that the participant is alive and out of hospital
- Secondary Outcome Measures
Name Time Method Total length of hospital stay 30 days Number of nights spent in hospital
Number of nights that a participant spends at home Day 30 and 90 Hospital length of stay Between the date of surgery and hospital discharge (primary admission) Number of nights spent in hospital
Hospital readmission 30 days Readmission to hospital following discharge
Return to pre-surgery functioning Day 90 Participants ability to return to work or usual home activities as measured by item 8 of the Quality of Recovery - 15 score. This will be scored on a 10 point numeric scale. Higher scores represent better outcomes as reported by the patient.
Reoperation Day 30 Number of unplanned operations
Mortality Day 30 and 1 year Number of participants who die within 30 days or 1 year of surgery
Morbidity Day 5 Whether or not a participant has morbidity as measured using the post operative morbidity survey
Quality of Recovery - 15 score (QoR-15) Day 90 A 15 question survey, where a number of different items are scored on a 10 point numeric scale. Higher scores represent better outcomes as reported by the participant
Total length of critical care stay First 30 days after surgery Number of nights spent in Critical Care
Complications From the date and time of surgery until hospital discharge Whether or not a participant develops complications as measured using Clavien Dindo