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Trial registered on ANZCTR
Registration number
ACTRN12617001462370
Ethics application status
Approved
Date submitted
11/10/2017
Date registered
16/10/2017
Date last updated
16/10/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Preoperative nutritional status as a predictor of postoperative fatigue in patients undergoing cardiac or vascular surgery
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Scientific title
Assessing the relationship between pre-operative nutritional status and post-operative fatigue in patients undergoing cardiac or vascular surgery
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Secondary ID [1]
293109
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Nil known
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Universal Trial Number (UTN)
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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:
Fatigue
305056
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Nutritional Status
305057
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Condition category
Condition code
Surgery
304377
304377
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0
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Other surgery
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Diet and Nutrition
304401
304401
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0
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Other diet and nutrition disorders
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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
Participants in the study were cardiac and vascular surgical patients admitted in the elective or acute setting at a tertiary public hospital (Waikato Hospital, New Zealand) between December 2008 and February 2009. Prior to surgery included participants completed two questionnaires: the Mini Nutritional Assessment (MNA) questionnaire and the Identity Consequences Fatigue Score (ICFS) questionnaire. The duration of observation was from surgical admission until 6 months post operatively.
The MNA questionnaire was used to screen for preoperative nutritional status and consisted of two sections: screening and assessment. Using a scoring system, the screening section assessed loss of appetite, weight loss, mobility, psychological stress, acute disease, neuropsychological problems and BMI. Patients were then allocated into “normal” and “possible malnutrition” subgroups. If classified as “possible malnutrition”, then the patient would complete a more detailed assessment section evaluating their dietary history, and psychosocial and health status, including both mid- arm and calf circumferences.
The ICFS measured self-reports of patient fatigue and, following preoperative completion, was then posted to participants for self-completion at 2 and 6 months postoperatively. Patients were contacted by phone to ensure receipt of questionnaires and a reminder phone call was conducted if a completed questionnaire was not received within a week, through a pre-paid envelope provided.
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Intervention code [1]
299353
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Early Detection / Screening
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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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The relationship between pre-operative nutritional status and post-operative fatigue assessed using pre-operative nutritional status (assessed by the MNA questionnaire) and post-operative fatigue (assessed by the ICFS questionnaire).
Bi-serial-correlation tested the relationship between nutritional status (dichotomous variable: 0-11 possible malnutrition and 11-14 normal nutrition) and fatigue, due to the non-linear intervals on the scale. Unpaired t-tests identified variables for construction of multiple regression analyses, while association between categorical variables was investigated using Pearson’s chi-square statistics. Mixed ANOVA detected differences in mean measurements of fatigue between the two nutritional groups. In addition, repeated measures over the three time points and the interactional effect between time and nutritional status were analysed.
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Assessment method [1]
303626
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Timepoint [1]
303626
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At 2 and 6 months post operatively
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Primary outcome [2]
303627
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Comparison of changes in the levels of post-operative fatigue for “normal” and “possible malnutrition” nutritional groups. Contrast analysis was performed to identify the significance of fatigue change between patients pre-operatively and 2 months postoperatively, as well as the change in fatigue between 2 and 6 months post-operatively.
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Assessment method [2]
303627
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Timepoint [2]
303627
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Over 6 months post operatively
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Secondary outcome [1]
339685
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Assess the influence of nutritional and surgical variables on post-operative fatigue levels.
Multiple regression studies were constructed to identify nutritional status variables (as per the MNA and ICFS score) and other co-morbidities (including smoking status, pre-existing renal disease, major surgery and re-operation for vascular surgery) which best explained levels of fatigue. Variables were selected by first including all factors and then removing all that were not significant. Significance unless otherwise specified was defined as p<0.05.
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Assessment method [1]
339685
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Timepoint [1]
339685
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At 2 and 6 months post operatively
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Eligibility
Key inclusion criteria
Cardiac and vascular surgical patients admitted in the elective or acute setting at a tertiary public hospital (Waikato Hospital, New Zealand) between December 2008 and February 2009.
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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
- under the age of 18
- had cancer or severe dementia.
- declined consent for the study
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Data was compiled and analysed using SPSS version 22 software (IBM Corporation, Armonk, NY, USA) and GraphPad Prism 5.0. Bi-serial-correlation tested the relationship between nutritional status (dichotomous variable: 0-11 possible malnutrition and 11-14 normal nutrition) and fatigue, due to the non-linear intervals on the scale. Unpaired t-tests identified variables for construction of multiple regression analyses, while association between categorical variables was investigated using Pearson’s chi-square statistics. Mixed ANOVA detected differences in mean measurements of fatigue between the two nutritional groups. In addition, repeated measures over the three time points and the interactional effect between time and nutritional status were analysed. Contrast analysis was performed to identify the significance of fatigue change between patients pre-operatively and 2 months postoperatively, as well as the change in fatigue between 2 and 6 months post-operatively. Multiple regression studies were constructed to identify nutritional status and other co-morbidities which best explained levels of fatigue. Variables were selected by first including all factors and then removing all that were not significant. Significance unless otherwise specified was defined as p<0.05.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/12/2008
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Date of last participant enrolment
Anticipated
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Actual
28/02/2009
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Date of last data collection
Anticipated
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Actual
30/09/2009
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Sample size
Target
100
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Accrual to date
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Final
135
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Recruitment outside Australia
Country [1]
9279
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New Zealand
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State/province [1]
9279
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Hamilton
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Funding & Sponsors
Funding source category [1]
297739
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University
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Name [1]
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Waikato Clinical School, University of Auckland
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Address [1]
297739
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Waikato Clinical Campus
Peter Rothwell Academic Centre
Waikato Hospital
Pembroke Street
Private Bag 3200
Hamilton 3240
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Country [1]
297739
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New Zealand
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Primary sponsor type
University
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Name
Waikato Clinical School, University of Auckland
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Address
Waikato Clinical Campus
Peter Rothwell Academic Centre
Waikato Hospital
Pembroke Street
Private Bag 3200
Hamilton 3240
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Country
New Zealand
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Secondary sponsor category [1]
296772
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None
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Name [1]
296772
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Address [1]
296772
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Country [1]
296772
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
298802
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Northern Y Ethics Committee
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Ethics committee address [1]
298802
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140
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Ethics committee country [1]
298802
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New Zealand
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Date submitted for ethics approval [1]
298802
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Approval date [1]
298802
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08/08/2008
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Ethics approval number [1]
298802
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NTY/08/08/080
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Summary
Brief summary
Nutritional status is an important prognostic factor in surgical patients. Fatigue is common after surgery and if unmanaged may impair healing and recovery. Objectives: Examine the relationship between pre-operative nutritional status and post-operative fatigue at 2 and 6 months. Compare changes in the levels of post-operative fatigue for different nutritional groups over 6 months. Assess the influence of nutritional and surgical variables on post-operative fatigue levels at 2 and 6 months. Design: Using the Mini Nutritional Assessment questionnaire, preoperative nutritional status was screened and patients categorised to “normal nutrition” or “possible malnutrition”. Self-reports of patient fatigue were measured preoperatively, and 2 and 6 months postoperatively with the Identity Consequences Fatigue Score (ICFS) questionnaire.
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Trial website
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Trial related presentations / publications
N. Chiang, B. Leung, P. Haggart, T.M. Vasudevan. Pre-operative Nutritional Status as a predictor of Post-operative Fatigue. ANZSVS Meeting: Sydney, Australia. October 2009. B. Leung, N. Chiang, P. Huggart, T.M. Vasudevan. Pre-operative Nutritional Status: An indicator of post-operative Fatigue. NZVS Meeting: New Plymouth, NZ. February, 2010.
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Public notes
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Contacts
Principal investigator
Name
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Dr Nathaniel Chiang
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Address
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Austin Hospital
145 Studley Road
Heidelberg VIC 3084
AUSTRALIA
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Country
78270
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Australia
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Phone
78270
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+61432602149
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Fax
78270
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Email
78270
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[email protected]
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Contact person for public queries
Name
78271
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Nathaniel Chiang
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Address
78271
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Austin Hospital
145 Studley Road
Heidelberg VIC 3084
AUSTRALIA
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Country
78271
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Australia
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Phone
78271
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+61432602149
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Fax
78271
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Email
78271
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[email protected]
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Contact person for scientific queries
Name
78272
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Nathaniel Chiang
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Address
78272
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Austin Hospital
145 Studley Road
Heidelberg VIC 3084
AUSTRALIA
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Country
78272
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Australia
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Phone
78272
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+61432602149
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Fax
78272
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Email
78272
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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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