Clinical Trials Logo

Clinical Trial Summary

The incidence of childhood obesity is at epidemic levels and increasing in the UK. Obese adults are considered a high-risk group of patients for general anaesthesia with published national guidelines on the best practice management. The proportion of children presenting for a procedure under general anaesthesia in the UK who are overweight or obese is currently unknown.

Obese children are perceived to be at greater risk of complications from general anaesthesia. Previous non-UK studies suggest they take longer to recover from anaesthesia, require more medications to combat nausea and vomiting and are at greater risk of complications that may threaten their airway and breathing.

This study involves reviewing the anaesthetic care record and patient notes to collect information relating to general anaesthesia and basic demographic data in children aged 2-16 years presenting for a procedure under general anaesthesia.

The aims of this study are to establish the prevalence of obesity in the paediatric surgical population (i.e. the proportion of children attending UK hospitals for procedures under general anaesthesia who are overweight or obese) and to ascertain whether obese children are at increased risk compared to their healthy weight counterparts.

This information will be used with the goal of reducing avoidable harm both at national and local level in the future.


Clinical Trial Description

IRAS 248493 REC 18/WM/0394 NIHR CPMS ID 40368

Hypotheses

1. Overweight and obese children commonly present for procedures under general anaesthesia.

2. Obese children are at higher risk of perioperative adverse events compared to their healthy-weight counterparts.

3. There is wide variation in paracetamol drug dosing amongst obese children.

4. Obese children may be more likely to present for certain surgery compared to their healthy-weight counterparts.

This observational cohort study will take place in NHS hospitals in the UK with trainee anaesthetists affiliated to the Paediatric Anaesthesia Trainee Research Network (PATRN). To increase coverage of sites in the UK, the project will be advertised through other trainee research networks including Research and Audit Federation of Trainees (RAFT) and through the Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) linkmen.

Each hospital taking part will have a nominated anaesthetic consultant and trainees who will act as local investigators collecting data. Data will be collected for all children aged 2-16 years weighing >12kg presenting for a procedure involving general anaesthesia during the defined study period. This will be one week (7 consecutive days). Using previous PATRN audit projects as a guide, we aim to enrol approximately 90 local sites which will give an estimated total of 7590 children attending for a procedure under general anaesthesia during the study period.

Patients will be identified by local trainee investigators (independent of delivery of anaesthesia but part of the anaesthetic department of the hospital) from operating department lists on the days of the study. Data will be collected on all eligible patients who undergo a procedure under general anaesthesia during the study period. Similar data collection tools have been used in previous PATRN audit projects.

Data will be collected from the paper or electronic anaesthetic record and clinical notes. Only routine clinical data will be included and where this is unavailable the domain will be left blank. Data will be collected using a single paper case report form (CRF) per patient. This will be initiated by the anaesthetist in the operating theatre and completed by recovery staff in PACU. Patient identifiable data in the form of hospital number and date of birth will be collected on the CRF for traceability in terms of missing data.

To calculate BMI, age (to the nearest month), gender, height and weight are required for each patient. It is anticipated that all hospitals would routinely measure weight but some hospitals may not routinely measure height prior to a procedure under general anaesthesia. NICE guidelines currently recommend that clinical judgement should be used to decide when to measure a person's height and weight, including at routine health checks. The preoperative setting is a specific health check prior to undergoing general anaesthesia and therefore an appropriate time to measure a child's height and weight.

Height will be measured with shoes removed to the nearest 0.1cm using a height measure with the child's head positioned so that the Frankfurt plane is horizontal. Body weight will be measured with patients lightly clad, to the nearest 0.1kg using a calibrated electronic weighing scale. If the local site is unable to collect age, gender, height and weight we will ask for the case to be logged and uploaded but for no other data to be collected. It is important to know how many cases we are unable to include in the analysis due to incomplete data.

Other information that would routinely be recorded within the clinical notes relating to the patients physical status, surgery, anaesthetic and specific perioperative adverse events will also be collected on the CRF.

The completed CRF will be taken directly to a secure location accessible by the local investigator. The data will be entered electronically via a secure encrypted connection into an online portal managed by Aberdeen University. The software used for data capture will be REDCap (Research Electronic Data Capture - http://www.project-redcap.org). REDCap is a mature, secure web application for building and managing online surveys and databases.

Each dataset entered will generate a unique identifier (ie the data will be pseudonymised); local investigators will be asked to keep a log of their unique identifiers linked to local hospital identification numbers. The hospital number will remain within the respective trusts, meaning only the local NHS staff responsible for care have access to personal identifying information. The study database will be closed for data entry a number of weeks after the study completion date. The anonymised responses from participating hospitals across the country will be analysed by a team of researchers. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT03994419
Study type Observational
Source University Hospital Southampton NHS Foundation Trust
Contact Zoe A Burton, MBBCh
Phone 00447921865041
Email UHS.PEACHY@nhs.net
Status Not yet recruiting
Phase
Start date September 9, 2019
Completion date October 6, 2019

See also
  Status Clinical Trial Phase
Recruiting NCT05354245 - Using a Complex Carbohydrate Mixture to Steer Fermentation and Improve Metabolism in Adults With Overweight and Prediabetes (DISTAL) N/A
Completed NCT03602001 - Attentive Eating for Weight Loss N/A
Recruiting NCT06269159 - The Power of 24-hour: Co-designing Intervention Components
Completed NCT03377244 - Healthy Body Healthy Souls in the Marshallese Population N/A
Completed NCT02996864 - Location-based Smartphone Technology to Guide College Students Healthy Choices Ph II N/A
Completed NCT04647149 - Effects of Early and Delayed Time-restricted Eating in Adults With Overweight and Obesity N/A
Terminated NCT03914066 - A Group-based Treatment of Overweight and Obesity in Primary Care N/A
Completed NCT03685656 - Effect of ANACA3 Slimming Gel on Loss of Abdominal and Thigh Circumferences in Healthy Volunteers N/A
Completed NCT05051579 - A Study of LY3502970 in Participants With Obesity or Overweight With Weight-related Comorbidities Phase 2
Completed NCT04611477 - Effect of Synbiotic 365 on Body Composition in Overweight and Obese Individuals N/A
Active, not recruiting NCT05330247 - Cut Down on Carbohydrate in the Dietary Therapy of Type 2 Diabetes - The Meal Box Study N/A
Completed NCT03599115 - Effects of Inhibitory Control Training in Eating Behaviors N/A
Recruiting NCT06094231 - Treating Patients With Renal Impairment and Altered Glucose MetAbolism With TherapeutIc Carbohydrate Restriction and Sglt2-Inhibiton - a Pilot Study N/A
Recruiting NCT05938894 - Train Your Brain - Executive Function N/A
Recruiting NCT05987306 - A Self-compassion Focused Intervention for Internalized Weight Bias and Weight Loss N/A
Completed NCT03792685 - Looking for Personalized Nutrition for Obesity/Type 2 Diabetes Mellitus Prevention N/A
Completed NCT05055362 - Effect a Honey, Spice-blended Baked Good Has on Salivary Inflammation Markers in Adults: a Pilot Study N/A
Completed NCT04520256 - Rapid Evaluation of Innovative Intervention Components to Maximize the Health Benefits of Behavioral Obesity Treatment Delivered Online: An Application of Multiphase Optimization Strategy Phase 2/Phase 3
Completed NCT04979234 - A Single Centre, Prospective Feasibility Study to Evaluate the Efficacy of an Endoluminal-suturing Device (Endomina) on Severe Obstructive Sleep Apnea Syndrome N/A
Not yet recruiting NCT06018415 - Effects of Early and Late Time-restricted Eating on Overweight Adults With Metabolic Syndrome N/A