CArdiovaSCulAr outcomes after major abDominal surgEry: study protocol for a multicentre, observational, prospective, international audit of postoperative cardiac complications after major abdominal surgery

Kouli, Omar; Bhangu, Aneel; Biccard, Bruce; Docherty, Annemarie B; El‐Boghdadly, Kariem; Glasbey, James C; Harrison, Ewen M; Martin, J.; Moug, Susan; Mouton, R. P.; Phull, Mandeep; Pinkney, Thomas; Richards, Toby; Smart, Neil; Thickett, David; Blanco-Colino, Ruth; Brindl, Niall; Brown, Sam P.; Cambridge, William; Chaudhry, Daoud; Gressmann, Kassandra; Gujjuri, Rohan R; Hilder, Amie; Jaffer, Alisha; Jakaityte, Ieva; Kamarajah, Sivesh K; Kawka, Michal; Matey, Esther; McLean, Kenneth A; ergo, Aleksandra; Liu, Christopher; Murray, Victoria; Ooi, Setthasorn Z.Y.; Pereira, Irène S.; Riad, Aya M.; Sgrò, Alessandro; Shafi, Shiraz Q.; Trout, Isobel M; Turňa, Adam; Varghese, Chris; Xu, William

doi:10.1016/j.bja.2022.02.012

Cited by 3 publications

(4 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of 24,246 eligible patients in the dataset undergoing major abdominal surgery, 24,203 had complete 30-day follow-up data (Fig. 1, online Supporting Information [3][4][5][6][7][8][9][10][11][12][13][14][15][16]) days (Fig. 2b and c).…”

Section: Resultsmentioning

confidence: 99%

“…CArdiovaSCulAr outcomes after major abDominal surgery (CASCADE) was an international, observational, multicentre, prospective cohort study across Europe, conducted according to a prespecified published protocol [6]. Any centre conducting eligible surgery in Europe was invited to participate, with prospective identification of patients by local collaborators across a pre-defined, two-week data collection window between 23 January and 1 May 2022.…”

Section: Methodsmentioning

confidence: 99%

“…Postoperative cardiac complications are recognised as being among the most clinically significant and are associated with morbidity and mortality [6,7]. Peri-operative myocardial injury occurs commonly among asymptomatic patients undergoing non-cardiac surgery and its strong prognostic significance has increased the focus on cardiovascular outcomes in research regarding perioperative outcomes [8].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of postoperative cardiovascular complications on 30‐day mortality after major abdominal surgery: an international prospective cohort study

2024

Anaesthesia

View full text Add to dashboard Cite

SummaryCardiovascular complications after major surgery are associated with increases in morbidity and mortality. There is confusion over definitions of cardiac injury or complications, and variability in the assessment and management of patients. This international prospective cohort study aimed to define the incidence and timing of these complications and to investigate their impact on 30‐day all‐cause mortality. We performed a prospective, international cohort study between January 2022 and May 2022. Data were collected on consecutive patients undergoing major abdominal surgery in 446 hospitals from 28 countries across Europe. The primary outcome measure was cardiovascular complications as defined by the Standardised Endpoints for Perioperative Medicine‐Core Outcome Measures for Perioperative and Anaesthetic Care initiative up to 30 days after surgery. The secondary outcome was 30‐day postoperative mortality. This study included 24,203 patients, of whom 611 (2.5%) developed cardiovascular complications. In total, 458 (1.9%) patients died within 30 days of surgery, of which 123 (26.9%) deaths were judged to be cardiac‐related. Mortality rates were higher in patients who developed postoperative cardiovascular complications than in those who did not (19.8% vs. 1.4%), which persisted after risk adjustment (hazard ratio (95%CI) 4.15 (3.14–5.48)). We estimated an absolute risk reduction (95%CI) of 0.4 (0.3–0.5) in mortality in the absence of all cardiovascular complications. This would confer a relative risk reduction in mortality of 21.1% if all cardiovascular complications were prevented. Postoperative cardiovascular complications are relatively common and occur early after major abdominal surgery. However, over 1 in 5 postoperative deaths were attributable to these complications, highlighting an important area for future randomised trials.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of postoperative cardiovascular complications on 30‐day mortality after major abdominal surgery: an international prospective cohort study

2024

Anaesthesia

View full text Add to dashboard Cite

show abstract

“…We used a prespecified case report form to collect data on patient and surgical characteristics and 30-day outcomes for each patient [16]. For this pre-planned secondary analysis we used the following variables from the CASCADE dataset: age (y); sex (male or female); BMI (kg.m -2 ); ASA physical status (1-5); smoking status; surgical indication (benign or malignant); surgical urgency (elective, intervention planned in advance of admission or emergency, intervention planned after admission); and surgical approach (open or minimally invasive).…”

Section: Methodsmentioning

confidence: 99%

Association between multimorbidity and postoperative mortality in patients undergoing major surgery: a prospective study in 29 countries across Europe

2024

Anaesthesia

View full text Add to dashboard Cite

SummaryBackgroundMultimorbidity poses a global challenge to healthcare delivery. This study aimed to describe the prevalence of multimorbidity, common disease combinations and outcomes in a contemporary cohort of patients undergoing major abdominal surgery.MethodsThis was a pre‐planned analysis of a prospective, multicentre, international study investigating cardiovascular complications after major abdominal surgery conducted in 446 hospitals in 29 countries across Europe. The primary outcome was 30‐day postoperative mortality. The secondary outcome measure was the incidence of complications within 30 days of surgery.ResultsOf 24,227 patients, 7006 (28.9%) had one long‐term condition and 10,486 (43.9%) had multimorbidity (two or more long‐term health conditions). The most common conditions were primary cancer (39.6%); hypertension (37.9%); chronic kidney disease (17.4%); and diabetes (15.4%). Patients with multimorbidity had a higher incidence of frailty compared with patients ≤ 1 long‐term health condition. Mortality was higher in patients with one long‐term health condition (adjusted odds ratio 1.93 (95%CI 1.16–3.23)) and multimorbidity (adjusted odds ratio 2.22 (95%CI 1.35–3.64)). Frailty and ASA physical status 3–5 mediated an estimated 31.7% of the 30‐day mortality in patients with one long‐term health condition (adjusted odds ratio 1.30 (95%CI 1.12–1.51)) and an estimated 36.9% of the 30‐day mortality in patients with multimorbidity (adjusted odds ratio 1.61 (95%CI 1.36–1.91)). There was no improvement in 30‐day mortality in patients with multimorbidity who received pre‐operative medical assessment.ConclusionsMultimorbidity is common and outcomes are poor among surgical patients across Europe. Addressing multimorbidity in elective and emergency patients requires innovative strategies to account for frailty and disease control. The development of such strategies, that integrate care targeting whole surgical pathways to strengthen current systems, is urgently needed for multimorbid patients. Interventional trials are warranted to determine the effectiveness of targeted management for surgical patients with multimorbidity.

show abstract

Study management strategies to optimize student‐ and trainee‐led collaborative research

2022

ANZ Journal of Surgery

Self Cite

View full text Add to dashboard Cite

The collaborative research model is a powerful approach to answering surgical research questions that empowers and inspires medical students and trainees. The Opioid PrEscRiptions and usage After Surgery (OPERAS) study is a student-and trainee-led international multi-centre prospective cohort study developed in Australia and Aotearoa New Zealand. In this article, we will discuss (i) how the OPERAS study was conceptualized and structured; (ii) the channels through which information and education were communicated to collaborators; (iii) how data was stored in a secure and user-friendly fashion and (iv) the lessons learned and expected goals for the future. We aim to describe how collaborative research studies can be designed to support early career researchers to make valuable contributions to the literature. BackgroundCollaborative research has emerged as a powerful and empowering approach to conducting surgical research. 1 Following its origins in the West Midlands of the UK, the collaborative research model has been adopted internationally and across a diverse range of specialties.Australia and Aotearoa New Zealand have a strong track record of contributing to European collaborative studies, recently maturing as active leaders in developing and delivering student-and trainee-led collaborative studies.Student-and trainee-led collaborative research (hereon truncated to 'collaborative research') offers abundant opportunities

show abstract

CArdiovaSCulAr outcomes after major abDominal surgEry: study protocol for a multicentre, observational, prospective, international audit of postoperative cardiac complications after major abdominal surgery

Cited by 3 publications

References 8 publications

Impact of postoperative cardiovascular complications on 30‐day mortality after major abdominal surgery: an international prospective cohort study

Impact of postoperative cardiovascular complications on 30‐day mortality after major abdominal surgery: an international prospective cohort study

Association between multimorbidity and postoperative mortality in patients undergoing major surgery: a prospective study in 29 countries across Europe

Study management strategies to optimize student‐ and trainee‐led collaborative research

Contact Info

Product

Resources

About