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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT03864861
Other study ID # REDGERM04
Secondary ID
Status Not yet recruiting
Phase
First received
Last updated
Start date October 22, 2019
Est. completion date March 22, 2020

Study information

Verified date March 2019
Source Grupo Español de Rehabilitación Multimodal
Contact Javier M Ripollés-Melchor
Phone 34639776364
Email jramirez@unizar.es
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Methods National audit of a 90-day prospective observational cohort in which pre-defined postoperative complications were analyzed at 30 days of follow-up in adult patients undergoing elective bariatric surgery with or without an intensified recovery program (ERAS: Enhanced Recovery after Surgery) with any level of protocol compliance (0-100%)

Research Places Spanish Hospitals where this surgical intervention is carried out.

Objectives To determine the incidence of postoperative complications per patient and procedure, regardless of the degree of adherence to ERAS protocols and its impact on the hospital stay and postoperative complications including 30-day mortality.

Sample size For an alpha error of 5% (95% confidence) and an accuracy of 3% and estimating a number of patients with complications of 11%, the sample size calculation yields 460 patients, although the final sample size it may be smaller depending on the proportion of complications detected.

Inclusion criteria Patients older than 18 years who are going to be electively operated on for bariatric surgery regardless of their adherence to an ERAS intensified recovery program and the compliance level of the protocol (from 0-100%)

Statistical analysis Continuous variables will be described as mean and standard deviation, if it is a normal distribution, or median and interquartile range, if they are not normally distributed. Comparisons of continuous variables will be performed by one-way ANOVA or the Mann-Whitney test, as appropriate. A univariate analysis will be performed to test the factors associated with postoperative complications, hospital stay and death in the hospital. Univariate analyzes and hierarchical multivariate logistic regression models will be constructed to identify factors associated independently with these results and to adjust for differences in confounding factors. The factors will be introduced in the models based on their relationship with the univariate result (p <0.05), the biological plausibility and the low rate of missing data.


Description:

The results of this study will allow to identify, on the one hand, the type of patients presenting postoperative complications and, on the other hand, to identify those items of the ERAS protocols that are independently associated with a reduction in postoperative complications and hospital stay, which will allow to focus the perioperative efforts in those items that actually improve the postoperative outcomes.

Aim 1 will establish the number of patients developing predefined postoperative complications within 30 days of surgery in adult patients undergoing elective bariatric surgery with any compliance of an ERAS protocol (including patients with 0 compliance). This will allow us to determine the actual impact of these protocols.

Aim 2 will allow us to know the type of predefined complication presented by the patients included in the ERAS protocols and in patients undergoing bariatric surgery; This will allow, on the one hand, to have a starting point for future clinical trials, and, on the other hand, to focus efforts to avoid these complications.

Aim 3 will allow us to identify those perioperative items of ERAS protocols that are actually associated with a decrease in postoperative complications.

The proposed study will establish a real view of the number of patients presenting postoperative complications that will overcome the limitations of available retrospective studies and provide greater insight into the items of the protocols that are associated with decreased complications; on the other hand, the investigator's hypothesis is that the number of patients who develop predefined postoperative complications within 30 days of surgery decreases as there is greater compliance with the predefined ERAS protocol items


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 460
Est. completion date March 22, 2020
Est. primary completion date February 22, 2020
Accepts healthy volunteers
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria:

- All adult patients (aged =18 years) undergoing elective bariatric surgery and by any approach (Includes surgery with laparoscopic, assisted laparoscopic approach or open approach) in a participating hospital during the 30-day cohort period with a planned overnight stay.

Exclusion Criteria:

- Patients undergoing emergency surgery

- Endoscopic procedures

- Patients under 18 years of age

- Patients with previous bariatric surgery who undergo revision surgery

- Patients who refuse to participate

Study Design


Locations

Country Name City State
Spain Complejo Hospitalario Universitario de A Coruña A Coruna Coruña
Spain Hospital Universitario Príncipe de Asturias Alcalá de Henares Madrid
Spain Hospital Universitario Fundación Alcorcón Alcorcón Madrid
Spain Hospital Virgen de los Lirios de Alcoy Alcoy Alicante
Spain Hospital Universitario de Cruces Baracaldo Bizkaia
Spain Hospital Clínic Universitat de Barcelona Barcelona
Spain Hospital Universitario Sant Pau Barcelona
Spain Hospital Universitario Vall d´Hebrón Barcelona
Spain Hospital Universitario de Burgos Burgos
Spain Hospital Universitario Puerta del Mar Cadiz Cádiz
Spain Hospital General Universitario de Castellón Castellon de la Plana Castellón
Spain Hospital General Universitario de Ciudad Real Ciudad Real
Spain Hospital General Universitario de Elche Elche Alicante
Spain Hospital Universitario de Fuenlabrada Fuenlabrada Madrid
Spain Hospital Universitario Getafe Getafe Madrid
Spain Hospital Universitario de Guadalajara Guadalajara
Spain Hospital Universitario Jerez de La Frontera Jerez de La Frontera Cádiz
Spain Hospital Universitario de Gran Canaria Doctor Negrín Las Palmas
Spain Hospital Universitario Insular de Gran Canaria Las Palmas de Gran Canaria
Spain Hospital Clínico San Carlos Madrid
Spain Hospital de La Princesa Madrid
Spain Hospital General Universitario Gregorio Marañón Madrid
Spain Hospital Universitario 12 de Octubre Madrid
Spain Hospital Universitario Infanta Leonor Madrid
Spain Hospital Universitario La Paz Madrid
Spain Hospital Universitario Ramón y Cajal Madrid
Spain Hospital Universitario Puerta de Hierro Majadahonda Madrid
Spain Hospital Universitario Virgen del Victoria de Málaga Malaga Málaga
Spain Hospital Costa del Sol Marbella Málaga
Spain Hospital General Mateu Orfila Menorca
Spain Hospital de Mérida Mérida Badajoz
Spain Hospital Rey Juan Carlos Mostoles Madrid
Spain Hospital Universitario de Móstoles Mostoles Madrid
Spain Hospital General Universitario José María Morales Messeguer Murcia
Spain Hospital Universitario Central de Asturias Oviedo Asturias
Spain Complejo Hospitalario y Universitario de Pontevedra Pontevedra
Spain Hospital Universitario Quirón Madrid Pozuelo de Alarcon Madrid
Spain Hospital Universitario Parc Tauli Sabadell Barcelona
Spain Hospital de Sant Joan Despí Moisès Broggi Sant Joan d'Espi Barcelona
Spain Hospital Universitario Marqués de Valdecilla Santander
Spain Hospital Universitario Virgen de Valme Sevilla
Spain Hospital Universitario Virgen Macarena Sevilla
Spain Complejo Hospitalario de Toledo Toledo
Spain Hospital Universitario de Torrejón Torrejon de Ardoz Madrid
Spain Hospital Clínico Universitario de Valencia Valencia
Spain Hospital General Universitario de Valencia Valencia
Spain Hospital Universitario La Fe Valencia
Spain Hospital Clínico de Valladolid Valladolid
Spain Hospital Universitario Río Hortega Valladolid
Spain Hospital Universitario de Vic Vic Barcelona
Spain Hospital Universitario de Álava Vitoria
Spain Hospital Clínico Universitario Lozano Blesa Zaragoza
Spain Hospital Universitario Miguel Server Zaragoza

Sponsors (3)

Lead Sponsor Collaborator
Grupo Español de Rehabilitación Multimodal REDGERM, Sociedad Española de Cirugía de la Obesidad

Country where clinical trial is conducted

Spain, 

Outcome

Type Measure Description Time frame Safety issue
Primary Predefined mild-moderate-severe postoperative complications Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine were published by the European Perioperative Clinical Outcome (EPCO) definitions. Infectious complications, cardiovascular complications and other types of complications. Each complication will be graded as mild, moderate or severe. 30 days after surgery
Secondary In-hospital all-cause mortality The percentage of deaths within 30 days of surgery will be reported for each surgical category 30 days after surgery
Secondary ERAS Compliance Overall compliance will be calculated as the average of all pre- and intraoperative ERAS adapted elements, as specified in the ERAS society bariatric guidelines ERAS patients' guideline compliance will be categorised into quartiles 30 days after surgery
Secondary Duration of hospital stay The median hospital length of stay (LOS) following the start of surgery, overall, by survival status and by complication status will be reported. Post-operative LOS is the duration in days from the date of the end of surgery to the date of discharge from hospital. 30 days after surgery
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