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Trial registered on ANZCTR
Registration number
ACTRN12610000005055
Ethics application status
Approved
Date submitted
31/12/2009
Date registered
5/01/2010
Date last updated
27/10/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
Brain Injury in Surgery Study
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Scientific title
Incidence of cerebral ischemia in participants undergoing bowel surgery determined by post-operative magnetic resonance brain imaging with diffusion weighted imaging (DWI).
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Secondary ID [1]
1230
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None
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Universal Trial Number (UTN)
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Trial acronym
BISS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Peri-operative cerebral ischemia
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Condition category
Condition code
Stroke
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0
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Ischaemic
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Post-operative magnetic resonance (MRI) brain imaging with diffusion weighted imaging (DWI) and FLAIR sequences.
The MRI technique of DWI is a simple and non-invasive means of identifying areas of cerebral ischemia with high sensitivity and specificity. Increased DWI signal intensity change occurs within minutes of the ischemic event and remains “positive” for 7-14 days even in the absence of clinical signs of stroke. This allows areas of acute ischemia to be distinguished from old infarction. Each scan is estimated to take 20 minutes in duration.
Participants will also undergo clinical and cognitive assessments both pre- and post- operatively. Clinical and cognitive assessments will be performed within the week prior to surgery. The clinical assessment will be repeated between 3-7 days after the operation and then again at 6-8 weeks. Cognitive assessment will be repeated at 6-8 weeks only.
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Intervention code [1]
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Not applicable
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Comparator / control treatment
N/A
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Presence of new ischemic change on post-operative MRI brain scans with DWI in patients undergoing bowel surgery.
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Assessment method [1]
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Timepoint [1]
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The MRI brain scans will be performed once the participant is clinically stable at 3-7 days following their operation.
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Secondary outcome [1]
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Incidence of peri-operative stroke, transient ischemic attack and acute confusional state in bowel surgery patients.
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Assessment method [1]
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Timepoint [1]
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Participants will undergo a clinical assessment at 3-7 days following their operation.
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Eligibility
Key inclusion criteria
1.Thirty consecutive patients undergoing bowel surgery (right hemicolectomy, anterior resection or abdominoperineal resection) at the Auckland City Hospital. 2.Able to give informed consent. 3.Able to undergo the clinical and cognitive assessments 4.Able to tolerate a post-operative MRI brain scan.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1.Previous neurological disease, including stroke or transient ischemia attack (TIA), or cognitive impairment as determined by Abbreviated Mental Test Score (AMT<7), or past psychiatric disease that would interfere with the interpretation of clinical and radiological data.
2.Contraindications to MRI brain scanning including permanent pacemaker/implantable defibrillator, metallic foreign bodies, claustrophobia.
3.Any patient that the assessing clinician or treating surgeon or anaesthetist does not believe would be an appropriate candidate for the study.
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
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Reason for early stopping/withdrawal
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Date of first participant enrolment
Anticipated
1/09/2010
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Actual
19/01/2011
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Date of last participant enrolment
Anticipated
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Actual
19/05/2011
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
30
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Accrual to date
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Final
6
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Auckland
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Auckland District Health Board Neurology Residual Research Funds
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Address [1]
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Neurology Department
Level 8
Support Building
Auckland City Hospital
Park Road
Grafton
AUCKLAND 1023
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Country [1]
256222
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New Zealand
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Funding source category [2]
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Hospital
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Name [2]
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Auckland District Health Board A+ Trust
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Address [2]
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Auckland City Hospital, Park Road, Grafton, AUCKLAND 1023
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Country [2]
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New Zealand
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Primary sponsor type
Hospital
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Name
Auckland City Hospital Research Review Committee
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Address
Level 14
Support Building
Auckland City Hospital
Park Road
Grafton
AUCKLAND 1023
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern Y Regional Ethics Committee
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Ethics committee address [1]
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3rd Floor, BNZ Building, 354 Victoria Street, HAMILTON 3204
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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24/05/2010
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Approval date [1]
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20/10/2010
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Ethics approval number [1]
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NTY/10/06/052
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Summary
Brief summary
There is clear evidence that heart surgery can lead to clinically evident and asymptomatic brain injury. There is some debate as to whether this is due to clots forming in the heart and going to the brain, the need to use heart-lung bypass, anaesthetic factors, or other factors that occur during the operation such as low blood pressure leading to reduced blood flow to the brain. We wish to determine the risk of brain injury following bowel surgery and any factors that may predict this risk. This will be done by performing clinical and cognitive testing before and after surgery and magnetic resonance imaging brain scans in the week following surgery. The results of this study will be compared to those seen in heart surgery patients. The aim is to shed more light on the mechanisms of brain injury following surgery.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Cheryl Johnson
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Address
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C/o Older Adults and Home Health
Waitemata District Health Board
Private Bag 93-503
Takapuna
AUCKLAND 0740
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Country
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New Zealand
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Phone
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+6421393860
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Professor Alan Barber
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Address
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Neurology Department
Auckland City Hospital
Level 8
Auckland City Hospital
Park Road, Grafton
AUCKLAND 1023
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Country
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New Zealand
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Phone
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0064 9 923 6520
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Fax
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0064 9 367 7146
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Email
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[email protected]
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Contact person for scientific queries
Name
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Professor Alan Barber
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Address
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Neurology Department
Auckland City Hospital
Level 8
Auckland City Hospital
Park Road, Grafton
AUCKLAND 1023
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Country
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New Zealand
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Phone
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0064 9 923 6520
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Fax
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0064 9 367 7146
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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