ACUTE-Acute Surgical Care- Risk Factors and Outcomes for Patients in Need of Acute Surgical Care

Region Skane

Status: Enrolling

Conditions: Complication of Surgical Procedure; Complication of Treatment; Risk Factors; Long Term Effects After GI Bleeding; Complication of Anesthesia; Long Term Effects After Emergency Surgery

Treatments: Other: Observational study of different treatments and time to treatment

Study type: Observational

Funder types: Other

Identifiers

NCT05195697

2019-03583

Details and patient eligibility

About

Observational retrospective study of patients in need of acute surgical care admitted to Skåne University Hospital between 2009 and 2019.

Full description

At Skåne University Hospital approximately 6000 individuals are treated for acute abdominal diseases each year. Given the high number of patients, there is an urgent need to optimize acute surgical care. Lower complication rates would decrease hospital stay, health care costs as well as personal suffering.

Assessment instruments for risks and frailty are not validated for the acute setting and the investigators hypothesize there is room for improvement in prophylactic interventions and risk assessment. The investigators will study cohorts of patients with three different surgical diagnosis: acute pancreatitis, gastrointestinal bleeding and perforated ulcer aiming to identify risk factors for complications or death and to investigate assessment tools in this population. Using propensity score analysis, the investigators will try to identify treatment options associated with better outcome for subcohorts defined by frailty, comorbidity, age or gender. Specific factors of interest include: time to- and kind of treatment, handling of ongoing pharmacological therapy (anticoagulants, corticosteroids) and need for further treatments on a long time basis. The results from this project will be used in a future prospective study where prophylactic treatments and specific treatment options are studied.

Enrollment: 3,000 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria: Patients admitted to Skåne University hospital in need of acute surgical care -

Exclusion Criteria: Below 18 years old

Trial design

3,000 participants in 10 patient groups

Mild acute pancreatitis

Description:

Patients treated with mild acute pancreatitis during the study period

Treatment:

Other: Observational study of different treatments and time to treatment

Moderate acute pancreatitis

Description:

Patients treated with moderate acute pancreatitis during the study period

Treatment:

Other: Observational study of different treatments and time to treatment

Severe acute pancreatitis

Description:

Patients treated with severe acute pancreatitis during the study period

Treatment:

Other: Observational study of different treatments and time to treatment

Acute gastrointestinal bleeding

Description:

Patients treated with acute gastrointestinal bleeding during the study period

Treatment:

Other: Observational study of different treatments and time to treatment

Perforated ulcer

Description:

Patients treated with perforated ulcer during the study period

Treatment:

Other: Observational study of different treatments and time to treatment

Older than 70 years

Description:

Patients older than 70 years

Treatment:

Other: Observational study of different treatments and time to treatment

Less than 70 years

Description:

Patients younger than 70 years

Treatment:

Other: Observational study of different treatments and time to treatment

Prothrombotic medications

Description:

Patients on prothrombotic medications

Treatment:

Other: Observational study of different treatments and time to treatment

Frail patients

Description:

Patients with increased frailty score

Treatment:

Other: Observational study of different treatments and time to treatment

Reintervention group

Description:

Patients in need of reintervention

Treatment:

Other: Observational study of different treatments and time to treatment