Anesthesia Surgery Complications MEWS Failure to rescue
Conditions
Interventions
Control cohort
In the control cohort, nurses and ward doctors will routinely monitor patients in the postoperative period. A research assistant will register the study endpoints on a case record form
Sponsors
MUMC+ / VUmc / AMC
Eligibility
Inclusion criteria
Inclusion criteria: - Patients undergoing elective surgery with an indication for postoperative hospital stay - Meets at least one of the following BonnScore criteria: o Postoperative pain therapy with follow up o Patients older than 60 years o Patients older than 45 years and a rCRI greater than 2 o Patients with sAPGAR smaller than 5 rCRI: The The revised Cardiac Risk Index (rCRI) is a clinical prediction tool to estimate the risk of a patient for perioperative cardiac complications. The risk is determined based on the presence of ischemic heart disease, congestive heart failure, cerebrovascular disease (stroke or transient ischemic attack), diabetes requiring preoperative insulin use, chronic kidney disease (creatinine > 2 mg/dL), and/or undergoing suprainguinal vascular, intraperitoneal, or intrathoracic surgery. Surgical APGAR score: The surgical APGAR score is used to predict perioperative and postoperative morbidity and mortality based on predicted perioperative blood loss, intraoperative blood pressure and intraoperative heart rate. The score is calculated at the end of a surgical procedure. The lower the score, the higher the risk for postoperative complications.
Exclusion criteria
Exclusion criteria: - Cardiac surgery - Preoperative indication for medium care or ICU admission - No informed consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 30-day mortality | — |
Secondary
| Measure | Time frame |
|---|---|
| - Quality of recovery 30 days after surgery, incidence of myocardial infarction and heart failure, cardiac arrhythmias, kidney failure, pneumonia, embolic complications (pulmonary and stroke), surgical site infection and sepsis. - Length of stay in hospital, length of stay high care unit (ICU, MCU) - Postoperative health-related quality of life up to 1 year following surgery using the EQ-5D questionnaire - Time to implement rescue therapy usually requiring admission at medium care or intensive care unit - Hospital costs up to 12 months following surgery. - Cost-effectiveness with 30-days and 12-month time horizon | — |
Contacts
Public ContactChrista Boer
VU University Medical Center, Department of Anesthesiology
Outcome results
None listed