A Clinical Decision Support Trial to Reduce Intraoperative Hypotension
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 30,000
- 试验地点
- 4
- 主要终点
- Acute Kidney Injury (AKI)
研究概览
简要总结
The purpose of this study is to provide messages to providers if their patient is at high risk of developing intraoperative hypotension based on past medical history and co-morbidities preoperatively and minutes of hypotension intraoperatively.
详细描述
Preoperative decision support:
Based on the patient's past medical history and comorbidities providers received one of two messages in the preoperative section of the chart. If the patient had a past medical history of renal insufficiency, congestive heart failure, or ischemic heart disease the provider received a message that the patient was at a high risk of developing sequale of hypotension. If the patient had more than 15 minutes of hypotension (defined as a mean arterial pressure (MAP)<65mmHg) during a previous anesthetic, then the provider received a message that the patient was at high risk of developing intraoperative hypotension. Based on the past medical history of the patient, providers will receive zero, one or both messages.
Intraoperative decision support:
In the vitals signs section of the intraoperative record a line denoting the mean arterial pressure (MAP) was added. If the patient had more than 10 cumulative minutes of hypotension (defined as a MAP<65 mmHg) then a yellow alert was displayed in the lower right section of the screen. If the patient had more than 20 minutes of hypotension, then the alert was changed to red.
Data Analysis:
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •All patients undergoing surgery at any of the UCLA operative locations
排除标准
- •Patients less than age 18
- •Patients undergoing cardiac surgery or liver transplantation
结局指标
主要结局
Acute Kidney Injury (AKI)
时间窗: within 7 days post-surgery
Risk adjusted rate of postoperative AKI
次要结局
- Hypotension(1) For each month from 12 months before pathway go-live until 12 months after go-live.)