Acute High-risk Abdominal Surgery Study - an Optimized Perioperative Course (AHA)

Hvidovre University Hospital

Status: Completed

Conditions: Perforated Viscus; Intestinal Obstruction

Treatments: Procedure: AHA (Acute Highrisk Abdominalsurgery): Optimized Course

Study type: Interventional

Funder types: Other

Identifiers

NCT01899885

AHA-37855

Details and patient eligibility

About

The objective of this study is to implement an optimized perioperative course for patients undergoing acute high-risk abdominal surgery in order to improve the outcome.

The optimized perioperative course consists of a number of interventions carried out before, during and after surgery.

Full description

Emergency surgery is associated with high mortality rates, post-operative complications and prolonged duration of hospital admission. The investigators will implement a multidisciplinary optimized perioperative course consisting of a number of interventions carried out before, during and after surgery.

Hypothesis: An optimized perioperative course will reduce the 30-day mortality in emergency abdominal surgery patients.

The investigators will do a post-hoc analysis of the data registered.

Enrollment: 1,200 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients undergoing primary emergency laparotomy or laparoscopy
• patients undergoing reoperation after abdominal surgery.
• Age > 18 years

Exclusion criteria

• Appendectomy
• Emergency laparoscopic cholecystectomy
• Emergency diagnostic laparoscopy without intervention

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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1,200 participants in 2 patient groups

historic control group

No Intervention group

Description:

Standard treatment in the historic control group

Intervention group

Active Comparator group

Description:

AHA (Acute Highrisk Abdominalsurgery): Optimized Course: Intervention before, during and after abdominal surgery. Focus on fast track with multimodal standardized intervention: 1. standardized preparing for surgery including high dose antibiotics and epidural analgesia etc. and transfer to intermediate care before surgery (the post-anaesthesia care unit) 2. GDT-LiDCO fluid management pre-, per- and postoperative 3. Postoperative triage to 24 hour intermediate care based on ASA score and Surgical Apgar Score 4. Focus on early mobilization, fysiotherapy and optimal nutrition postoperatively

Treatment:

Procedure: AHA (Acute Highrisk Abdominalsurgery): Optimized Course