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Trial registered on ANZCTR
Registration number
ACTRN12618001046291
Ethics application status
Approved
Date submitted
10/06/2018
Date registered
22/06/2018
Date last updated
27/06/2023
Date data sharing statement initially provided
27/06/2023
Date results provided
27/06/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
An observational study of perioperative anaemia and transfusion in surgical patients at St George Hospital.
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Scientific title
An observational study of perioperative anaemia and transfusion in surgical patients at St George Hospital.
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Secondary ID [1]
295158
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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:
anaemia
308270
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iron deficiency
308271
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Condition category
Condition code
Blood
307283
307283
0
0
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Anaemia
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Metabolic and Endocrine
307367
307367
0
0
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Other metabolic 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
We will be investigating the presence of anaemia in surgical patients, within 2 months prior to surgery up to the date of their surgery. Anaemia will be defined by a Hb less than 120g/L in females and less than 130g/L in males.
We will also be investigating the prevalance of iron deficient anaemia, within 2 months prior to surgery. Iron deficiency anaemia will be defined as anaemia with ferritin level less than 30mcg/L, or ferritin level less than 100mcg/L and Transferrin Saturation (TSats) less than 16%, we will be investigating the presence of anaemia in surgical patients within 2 months of their surgery.
We will also be investigating the prevalance of anaemia of chronic disease, within 2 months prior to surgery. Anaemia of chronic disease is defined as anaemia with ferritin greater than 100mcg/L and TSats greater than 16%
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Intervention code [1]
301497
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Diagnosis / Prognosis
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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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Prevalence of anaemia (%) on patients hospital electronic blood test records
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Assessment method [1]
306240
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Timepoint [1]
306240
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2 months prior to surgery up to the date of their surgery
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Secondary outcome [1]
347942
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Prevalence of haematinic studies in patients with pre-operative anaemia (measured in %) on patients hospital electronic blood test records
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Assessment method [1]
347942
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Timepoint [1]
347942
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2 months prior to surgery up to the date of their surgery
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Secondary outcome [2]
347946
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Use of blood products peri-operatively at St George Hospital (measured by numbers of blood products transfused per surgical admission recorded on patients hospital electronic transfusion record
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Assessment method [2]
347946
0
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Timepoint [2]
347946
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during surgical admission (varaible depending on procedure)
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Secondary outcome [3]
347947
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Use of packed red cells peri-operatively at St George Hospital (measured by numbers of packed red cells transfused per surgical admission recorded on patients hospital electronic transfusion record
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Assessment method [3]
347947
0
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Timepoint [3]
347947
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during surgical admission (varaible depending on procedure)
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Secondary outcome [4]
347948
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Timing of first packed red cell transfusion as recorded on patients hospital electronic transfusion record
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Assessment method [4]
347948
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Timepoint [4]
347948
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measured in days from procedure
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Secondary outcome [5]
347951
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Proportion of patients in whom preoperative blood testing is not recorded (measured in %) on patients hospital electronic blood test records
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Assessment method [5]
347951
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Timepoint [5]
347951
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2 months prior to surgery up to the date of their surgery
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Eligibility
Key inclusion criteria
All surgical procedures performed at St George Hospital during 2017 in patients 16 years or older.
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Minimum age
16
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
All those undergoing a surgical procedure at St George Hospital under the age of 16 years.
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Convenience sample
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Timing
Retrospective
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Statistical methods / analysis
Descriptive statistics will be used to describe the dataset, normally distributed outcomes reported as mean plus or minus standard deviations and non-normal data as median and interquartile range (IQR). Categorical data will be reported as counts and proportions. Missing data will be examined and reported as such. No hypothesis tests are planned at this stage.
Patients that have had multiple procedures will have each procedure treated independently.
The following results will be extracted:
% prevalence of anaemia
% prevalence of transfusion
% prevalence of Iron studies in anaemic patients
The following subgroup analysis are planned.
Prevalence of anaemia by:
specialty,
procedural consultant,
endoscopy/operation,
elective/emergency,
age and gender,
ASA status,
booking to procedure interval and
procedure name.
Prevalence of transfusion of any blood product by:
specialty,
procedural consultant,
endoscopy/operation,
elective/emergency,
age and gender,
ASA status,
booking to procedure interval and
procedure name.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/07/2018
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Actual
1/08/2018
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Date of last participant enrolment
Anticipated
2/07/2018
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Actual
1/08/2018
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Date of last data collection
Anticipated
2/07/2018
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Actual
1/08/2018
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Sample size
Target
11000
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Accrual to date
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Final
7879
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
11119
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St George Hospital - Kogarah
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Recruitment postcode(s) [1]
22932
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2217 - Kogarah
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Funding & Sponsors
Funding source category [1]
299748
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Hospital
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Name [1]
299748
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Department of Anaesthesia, St George Hospital
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Address [1]
299748
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Gray St
Kogarah
Sydney
NSW 2217
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Country [1]
299748
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Australia
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Primary sponsor type
Hospital
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Name
Department of Anaesthesia, St George Hospital
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Address
Gray St
Kogarah
Sydney
NSW 2217
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Country
Australia
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Secondary sponsor category [1]
299086
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None
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Name [1]
299086
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Address [1]
299086
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Country [1]
299086
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
300638
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South Eastern Sydney Local Health District HREC
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Ethics committee address [1]
300638
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G71 East Wing Edmund Blacket Building Prince of Wales Hospital Avoca Street Randwick NSW 2031
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Ethics committee country [1]
300638
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Australia
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Date submitted for ethics approval [1]
300638
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22/05/2018
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Approval date [1]
300638
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26/06/2018
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Ethics approval number [1]
300638
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2018/ETH00187
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Summary
Brief summary
Pre-operative anaemia, as defined by the World Health Organisation criteria, has a prevalence in non-cardiac surgery of around 25% and is associated with poorer outcomes peri-operatively. It also increases the chance of transfusion and increases risk of death in cardiac surgery. Blood transfusion is often used to correct peri-operative anaemia and whilst life saving in acute major haemorrhage is a limited resource and, is itself associated with morbidity and mortality. It remains unclear if treating anaemia in the peri-operative period can positively influence morbidity or mortality. However benefit from patient blood management interventions, including pre-operative anaemia optimisation, has been shown to reduce the need for blood transfusion with possible trends towards improved patient outcomes. Guidelines have been published recommending identification and active management of preoperative anaemia. An excellent goal directed review has been undertaken by the Australian National Blood Authority and also supports identification and optimisation of pre-operative anaemia. A preliminary look reviewing colorectal patients over a six month period in 2017 was recently undertaken at St George. Of the 171 elective operative cases found, ninety had a preoperative haemoglobin reported thirty of which were anaemic (33% of those who had a haemoglobin). Eight patients were transfused during the peri-operative period, the majority of whom were anaemic before surgery. This pilot study supports the published literature, and implies the problem of pre-operative anaemia is present at St George and currently insufficiently managed. Pre-operative anaemia may be an optimisable risk factor for our patients at St. George, first however we need to understand which patient groups are at greatest risk, their current management (blood product transfusions) and then how and where to focus our efforts. This work has not been previously undertaken at St George. The primary aim of the proposed study is to document the prevalence of anaemia pre-operatively and transfusion practice for all patients having a procedure in 2017 at St George Hospital. Secondary aims include the documentation of anaemia according to surgical speciality, of pre-operative iron deficiency anaemia, anaemia of chronic disease and of blood product transfusions according to patient demographics and surgical speciality. The study will also examine the timings from booking to surgery and pre-operative assessment to surgery to consider how best to optimise Haemoglobin (Hb) during the patients pre-operative pathway.
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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
84298
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Dr Ilana Delroy Buelles
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Address
84298
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Dept of Anaesthesia
Gray St
St George Hospital
Kogarah
NSW 2217
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Country
84298
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Australia
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Phone
84298
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+61 2 9113 1111
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Fax
84298
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Email
84298
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[email protected]
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Contact person for public queries
Name
84299
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Matthew Miller
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Address
84299
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Dept of Anaesthesia
Gray St
St George Hospital
Kogarah
NSW 2217
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Country
84299
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Australia
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Phone
84299
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+61 2 9113 1111
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Fax
84299
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Email
84299
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[email protected]
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Contact person for scientific queries
Name
84300
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Matthew Miller
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Address
84300
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Dept of Anaesthesia
Gray St
St George Hospital
Kogarah
NSW 2217
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Country
84300
0
Australia
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Phone
84300
0
+61 2 9113 1111
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Fax
84300
0
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Email
84300
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
not ethically approved to share data
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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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