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Trial registered on ANZCTR
Registration number
ACTRN12617000522314
Ethics application status
Approved
Date submitted
21/03/2017
Date registered
10/04/2017
Date last updated
14/02/2020
Date data sharing statement initially provided
14/02/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Frailty in patients undergoing major limb amputation for peripheral arterial disease
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Scientific title
Frailty in patients undergoing major limb amputation for peripheral arterial disease: a retrospective cohort study
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Secondary ID [1]
291489
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None
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Universal Trial Number (UTN)
U1111-1194-4554
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Frailty
302557
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Condition category
Condition code
Cardiovascular
302089
302089
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0
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Diseases of the vasculature and circulation including the lymphatic system
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Surgery
302228
302228
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0
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Other surgery
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Intervention/exposure
Study type
Observational
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Patient registry
False
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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
The frailty characteristics of patients undergoing major lower limb amputation at one of the hospitals run by Aneurin Bevan University Health Board in South East Wales from January 2010 until January 2017 will be recorded to determine the effects of frailty on outcome, and compared to established risk prediction models. We will record basic demographics, comorbidity (in the form of the Charlson Comorbidity Index), functional status (Katz score), residential status, Waterlow score, pre-operative blood tests and ECG, and pre-operative haemodynamics (highest heart rate and lowest blood pressure on the day of surgery). The Addenbrookes Vascular Frailty Score will be calculated, along with generic models for outcome following amputation. In all cases, pre-operative values will be collected.
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Intervention code [1]
297558
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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All-cause mortality
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Assessment method [1]
301527
0
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Timepoint [1]
301527
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12 months
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Secondary outcome [1]
332927
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Post-operative length of inpatient stay during index admission
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Assessment method [1]
332927
0
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Timepoint [1]
332927
0
This will be Censored at the end of the study for patients who are still inpatients
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Secondary outcome [2]
332928
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Re-admission to hospital following discharge
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Assessment method [2]
332928
0
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Timepoint [2]
332928
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12 months
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Secondary outcome [3]
332929
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Discharge destination
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Assessment method [3]
332929
0
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Timepoint [3]
332929
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Time of discharge
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Secondary outcome [4]
333416
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Successful mobilisation with prosthesis as assessed by review of medical and rehabilitation notes.
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Assessment method [4]
333416
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Timepoint [4]
333416
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12 months
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Eligibility
Key inclusion criteria
Patients undergoing lower limb amputation above the ankle at any hospital in South East Wales overseen by Aneurin Bevan University Health Board between January 2010 and January 2017
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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
Patients having amputation at or below the ankle.
Patients undergoing revision amputation which does not cross a major joint: for example a patient having revision of a below knee amputation to a shorter below knee amputation would be excluded, but a patient who has had a below knee amputation who has a revision to an above knee amputation need not be excluded.
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Retrospective
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Statistical methods / analysis
The Addenbrookes Vascular Frailty Score will be calculated, along with generic models for outcome following amputation. An amputation-specific frailty score will then be developed using stepwise logistic regression modelling, with mortality at 12 months as the primary outcome. Performance of the new tool will be compared to existing models.
Missing data is a common issue observational studies such as this one, so we will use multiple imputation methodology to account for missing data. During model generation, Information Criterion analysis will be used to select predictors. This will enable us to develop a parsimonious model which avoids over-fitting. Bootstrap methodology will then be used to assess performance of the model.
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Recruitment
Recruitment status
Withdrawn
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Reason for early stopping/withdrawal
Lack of funding/staff/facilities
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Date of first participant enrolment
Anticipated
18/04/2017
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Actual
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Date of last participant enrolment
Anticipated
28/06/2017
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Actual
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Date of last data collection
Anticipated
30/06/2017
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Actual
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Sample size
Target
300
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
8751
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United Kingdom
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State/province [1]
8751
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South East Wales
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Funding & Sponsors
Funding source category [1]
295969
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Hospital
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Name [1]
295969
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Royal Gwent Hospital
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Address [1]
295969
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Cardiff Road
Newport
Wales
NP20 2UB
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Country [1]
295969
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United Kingdom
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Primary sponsor type
Government body
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Name
Aneurin Bevan University Health Board
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Address
Clinical Research and Innovation Centre
St Woolos Hospital
Block C
Stow Hill
Newport, South Wales
NP20 4SZ
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Country
United Kingdom
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Secondary sponsor category [1]
294862
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Individual
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Name [1]
294862
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Christopher Twine
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Address [1]
294862
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Vascular Institute
Royal Gwent Hospital
Cardiff Road
Newport
NP20 2UB
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Country [1]
294862
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United Kingdom
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
297240
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Aneurin Bevan University Health Board Research Risk Review Committee
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Ethics committee address [1]
297240
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R&D Department Clinical Research & Innovation Centre St Woolos Hospital Block C, Stow Hill Newport, South Wales NP20 4SZ
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Ethics committee country [1]
297240
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United Kingdom
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Date submitted for ethics approval [1]
297240
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10/02/2017
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Approval date [1]
297240
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15/02/2017
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Ethics approval number [1]
297240
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SA/736/17
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Summary
Brief summary
Frailty is a multi-factorial concept encompassing the accumulated effects of comorbidity, mobility, social isolation, cognitive decline and poor nutritional status which build up with age. It is an increasing problem in our ageing population, and affects many outcomes following surgery. In patients undergoing major limb amputation, it is also likely to affect the ability to mobilise with a prosthetic limb. Little is known about which aspects of frailty are most important in patients undergoing major limb amputation. The aims of the project are: 1) Collect data on frailty-related factors in patients who have undergone major limb amputation, and information on outcomes, including whether the patient went on to successfully walk with a prosthesis. 2) Build statistical models to determine which factors are important in predicting outcomes. 3) Compare the performance of these models, which include specific measures of frailty, with generic models of outcome following major lower limb amputation.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
1594
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0
/AnzctrAttachments/372593-sa-736-17 approval letter.pdf
(Ethics approval)
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Attachments [2]
1600
1600
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/AnzctrAttachments/372593-Frailty in amputation protocol.docx
(Protocol)
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Contacts
Principal investigator
Name
73430
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Mr Christopher Twine
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Address
73430
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Vascular Institute
Royal Gwent Hospital
Cardiff Road
Newport
NP20 2UB
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Country
73430
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United Kingdom
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Phone
73430
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+44 1633 234234
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Fax
73430
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Email
73430
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[email protected]
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Contact person for public queries
Name
73431
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Graeme Ambler
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Address
73431
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Vascular Institute
Royal Gwent Hospital
Cardiff Road
Newport
NP20 2UB
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Country
73431
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United Kingdom
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Phone
73431
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+44 1633 234234
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Fax
73431
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Email
73431
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[email protected]
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Contact person for scientific queries
Name
73432
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Graeme Ambler
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Address
73432
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Vascular Institute
Royal Gwent Hospital
Cardiff Road
Newport
NP20 2UB
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Country
73432
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United Kingdom
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Phone
73432
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+44 1633 234234
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Fax
73432
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Email
73432
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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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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