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Trial registered on ANZCTR
Registration number
ACTRN12618000356268
Ethics application status
Approved
Date submitted
12/01/2018
Date registered
9/03/2018
Date last updated
28/04/2021
Date data sharing statement initially provided
27/02/2020
Date results provided
28/04/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Modelling risk of early post-operative complications for patients undergoing major lower limb amputation
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Scientific title
Modelling risk of in-hospital mortality and other early post-operative complications for patients undergoing major lower limb amputation entered into the United Kingdom National Vascular Registry
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Secondary ID [1]
293739
0
None
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Universal Trial Number (UTN)
U1111-1207-3753
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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:
Lower limb amputation
306106
0
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Condition category
Condition code
Cardiovascular
305234
305234
0
0
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Diseases of the vasculature and circulation including the lymphatic system
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Musculoskeletal
305235
305235
0
0
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Other muscular and skeletal disorders
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Surgery
305705
305705
0
0
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Other surgery
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Intervention/exposure
Study type
Observational
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Patient registry
True
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Target follow-up duration
30
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Target follow-up type
Days
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Description of intervention(s) / exposure
Patients undergoing major lower limb amputation who are entered into the United Kingdom National Vascular Registry
Duration of observation: from time of surgery until discharge from hospital.
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Intervention code [1]
299991
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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]
304388
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In-hospital mortality, as entered into the registry by the hospital or unit responsible for the patient's care, and validated by the surgeon responsible for the patient's care.
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Assessment method [1]
304388
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Timepoint [1]
304388
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The registry collects this outcome prospectively from the hospital or unit responsible for the patient's care and this is validated by the surgeon responsible for the patient's care. We will assess this retrospectively from the registry at the date of study commencement.
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Secondary outcome [1]
341791
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Length of post-operative stay in hospital, as entered into the registry by the hospital or unit responsible for the patient's care, and validated by the surgeon responsible for the patient's care.
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Assessment method [1]
341791
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Timepoint [1]
341791
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The registry collects this outcome prospectively from the hospital or unit responsible for the patient's care and this is validated by the surgeon responsible for the patient's care. We will assess this retrospectively from the registry at the date of study commencement.
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Secondary outcome [2]
341792
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Return to theatre during primary admission, as entered into the registry by the hospital or unit responsible for the patient's care, and validated by the surgeon responsible for the patient's care.
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Assessment method [2]
341792
0
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Timepoint [2]
341792
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The registry collects this outcome prospectively from the hospital or unit responsible for the patient's care and this is validated by the surgeon responsible for the patient's care. We will assess this retrospectively from the registry at the date of study commencement.
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Secondary outcome [3]
341793
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Re-admission to a higher level of care during primary admission, as entered into the registry by the hospital or unit responsible for the patient's care, and validated by the surgeon responsible for the patient's care.
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Assessment method [3]
341793
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Timepoint [3]
341793
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The registry collects this outcome prospectively from the hospital or unit responsible for the patient's care and this is validated by the surgeon responsible for the patient's care. We will assess this retrospectively from the registry at the date of study commencement.
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Secondary outcome [4]
341794
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Post-operative complications during primary admission, as entered into the registry by the hospital or unit responsible for the patient's care, and validated by the surgeon responsible for the patient's care.
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Assessment method [4]
341794
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Timepoint [4]
341794
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The registry collects this outcome prospectively from the hospital or unit responsible for the patient's care and this is validated by the surgeon responsible for the patient's care. We will assess this retrospectively from the registry at the date of study commencement.
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Eligibility
Key inclusion criteria
Patients undergoing major lower limb amputation entered into the United Kingdom National Vascular Registry between January 1st 2014 and December 31st 2016
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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 not entered into the database, or not undergoing major lower limb amputation during the study period.
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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
Logistic regression analysis will be used to develop models for the outcomes using pre-operative and peri-operative predictors. Information Criterion analysis will be used to select predictors in order to generate a parsimonious model which avoids over-fitting. Bootstrap methodology will then be used to assess performance of the model, and compare this to existing risk prediction models, as well as comparing the results obtained using complete case analysis with those obtained using multiple imputation, to assess the impact of the method of handling missing data on the results. Missing data will be handled using both complete case analysis and multiple imputation with chained equations.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
30/03/2018
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Actual
30/03/2018
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Date of last participant enrolment
Anticipated
30/05/2018
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Actual
30/05/2018
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Date of last data collection
Anticipated
30/06/2018
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Actual
30/06/2018
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Sample size
Target
8000
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Accrual to date
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Final
9549
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Recruitment outside Australia
Country [1]
9474
0
United Kingdom
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State/province [1]
9474
0
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Funding & Sponsors
Funding source category [1]
298352
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Government body
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Name [1]
298352
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Aneurin Bevan University Health Board
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Address [1]
298352
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Clinical Research and Innovation Centre
St Woolos Hospital
Block C
Stow Hill
Newport, South Wales
NP20 4SZ
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Country [1]
298352
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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]
297474
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Individual
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Name [1]
297474
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Christopher P Twine
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Address [1]
297474
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Vascular Institute
Royal Gwent Hospital
Cardi Road
Newport
NP20 2UB
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Country [1]
297474
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United Kingdom
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299347
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Wales REC 3
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Ethics committee address [1]
299347
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Health and Care Research Wales Support Centre Castlebridge 4 15-19 Cowbridge Road East Cardiff CF11 9AB
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Ethics committee country [1]
299347
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United Kingdom
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Date submitted for ethics approval [1]
299347
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17/01/2018
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Approval date [1]
299347
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29/01/2018
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Ethics approval number [1]
299347
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16/WA/0353
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Summary
Brief summary
The appropriate counselling of patients about peri- and post-operative risks is an essential part of the process of consent to surgery. Patients undergoing major lower limb amputation (MLLA) are a high risk group, with 30-day mortality rates of around 10%, making MLLA the highest risk common Vascular Surgery operation other than ruptured abdominal aortic aneurysm (AAA) repair: higher than elective open AAA repair (3.0%) or lower limb bypass (3.0%). Recent UK court rulings about patient consent have brought this issue to the fore for both patients and surgeons alike. This is an evolving area, but current advice is now that ‘surgeons are required to engage in a consenting process tailored to the individual patient with detailed, accurate and realistic explanations of the pros and cons of surgery.’ In procedures such as MLLA, where individual risk clearly varies widely between patients, it is important therefore to be able to quantify risks as accurately as possible. The issue of risk prediction for high-risk surgical procedures is also important in light of the advent of surgeon-specific outcome publication in the United Kingdom. In order to reduce the likelihood that high risk patients are denied procedures which they might otherwise have chosen to undergo as a result of a surgeon’s unwillingness to run the risk of poor outcomes publication, it is essential to be able to appropriately risk adjust these national audits. Using existing, prospectively collected data from the United Kingdom National Vascular Registry, we will develop models to predict the chances of complications after surgery including death in hospital, prolonged stay in hospital, need to go back to the operating theatre for another operation, post-operative chest infection and post-operative heart problems.
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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
80134
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Mr Christopher P Twine
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Address
80134
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Vascular Institute
Royal Gwent Hospital
Cardiff Road
Newport
NP20 2UB
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Country
80134
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United Kingdom
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Phone
80134
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+44 1633 234124
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Fax
80134
0
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Email
80134
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[email protected]
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Contact person for public queries
Name
80135
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Graeme Ambler
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Address
80135
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Division of Population Medicine
Cardiff University School of Medicine
3rd Floor Neuadd Meirionnydd
Heath Park
Cardiff
CF14 4YS
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Country
80135
0
United Kingdom
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Phone
80135
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+44 1633 234124
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Fax
80135
0
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Email
80135
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[email protected]
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Contact person for scientific queries
Name
80136
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Graeme Ambler
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Address
80136
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Division of Population Medicine
Cardiff University School of Medicine
3rd Floor Neuadd Meirionnydd
Heath Park
Cardiff
CF14 4YS
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Country
80136
0
United Kingdom
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Phone
80136
0
+44 1633 234124
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Fax
80136
0
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Email
80136
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
All data is available upon request from the UK National Vascular Registry, following approval of the data controlling committee
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When will data be available (start and end dates)?
Data is available currently upon request from the UK National Vascular Registry, following approval of the data controlling committee.
Start date: 30/06/2018
End date: No end date determined
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Available to whom?
All data is available upon request to anyone who wishes to access it from the UK National Vascular Registry, following approval of the data controlling committee
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Available for what types of analyses?
All data is available upon request from the UK National Vascular Registry, following approval of the data controlling committee, in order to achieve the aims in an approved proposal.
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How or where can data be obtained?
All data is available upon request from the UK National Vascular Registry, following approval of the data controlling committee. This can be done using the 'contact-us' form on the UK National Vascular Registry Website: https://www.vsqip.org.uk/contact-us/
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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
Source
Title
Year of Publication
DOI
Embase
Prognostic Risk Modelling for Patients Undergoing Major Lower Limb Amputation: An Analysis of the UK National Vascular Registry.
2020
https://dx.doi.org/10.1016/j.ejvs.2019.12.006
N.B. These documents automatically identified may not have been verified by the study sponsor.
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