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Trial registered on ANZCTR
Registration number
ACTRN12620000254998
Ethics application status
Approved
Date submitted
13/02/2020
Date registered
26/02/2020
Date last updated
6/06/2022
Date data sharing statement initially provided
26/02/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Examining associations between proteins in the blood and cognitive function among patients undergoing cardiac and non-cardiac surgery (BRAIN-S)
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Scientific title
Using biomarkers of neurological injury to predict cognitive function after cardiac and non-cardiac anaesthesia and surgery (BRAIN-S)
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Secondary ID [1]
300537
0
None
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Universal Trial Number (UTN)
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Trial acronym
BRAIN-S
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Delirium
316248
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Postoperative Cognitive Dysfunction
316249
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Condition category
Condition code
Anaesthesiology
314535
314535
0
0
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Anaesthetics
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Neurological
314536
314536
0
0
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Dementias
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Surgery
314537
314537
0
0
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Other surgery
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Mental Health
314616
314616
0
0
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Studies of normal psychology, cognitive function and behaviour
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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
Patients undergoing major elective cardiac and non-cardiac surgery will be recruited for this study. We will quantitate the change in two blood biomarkers of neurological damage (neurofilament light and tau) after cardiac compared to non-cardiac surgery. We will also examine these biomarkers to the subsequent neurocognitive outcomes in the postoperative period. All anaesthesia and surgery will be undertaken according to normal clinical practice. Participants will be followed over 3 months.
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Intervention code [1]
316841
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Early Detection / Screening
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Comparator / control treatment
This study will not involve the recruitment of control participants.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Fluctuating levels of neurofilament light.
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Assessment method [1]
322858
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Timepoint [1]
322858
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Blood samples will be taken prior to anaesthetic induction as a baseline measurement and again at 6 and 24 hours following surgery. Where possible a discharge and a 6-week blood sample will also be taken.
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Primary outcome [2]
322859
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Fluctuating levels of tau proteins.
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Assessment method [2]
322859
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Timepoint [2]
322859
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Blood samples will be taken prior to anaesthetic induction as a baseline measurement and again at 6 and 24 hours following surgery. Where possible a discharge and a 6-week blood sample will also be taken.
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Primary outcome [3]
322860
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Incidence of postoperative cognitive dysfunction as measured by a neuropsychological test battery. The components of the battery are as follows: memory (CERAD word learning test - immediate and delayed recall); attention (Trail Making A); executive function (Trail Making B, Digit Symbol Substitution Test, Clock Drawing Test); semantic fluency (controlled oral word association); verbal fluency (FAS); and motor function (Grooved Pegboard - dominant and non-dominant). We will also administer the Montreal Cognitive Assessment as part of the neuropsychological test battery (composite primary outcome).
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Assessment method [3]
322860
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Timepoint [3]
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7 days and 3 months postoperatively.
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Secondary outcome [1]
380036
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Postoperative delirium.
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Assessment method [1]
380036
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Timepoint [1]
380036
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Postoperative delirium will be assessed once daily up to 5 days following surgery or until discharge. Delirium assessments will be conducted by trained research staff using the 3 minute Diagnostic Confusion Assessment Method (3D-CAM).
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Eligibility
Key inclusion criteria
1. Greater than or equal to 65 years of age
2. Scheduled for elective cardiac or non-cardiac surgery (excluding valvular surgery, to avoid confounding factors of solid and air emboli)
3. Elective non-cardiac surgery procedures anticipated to last greater than one hour
4. Have no contraindication to neuropsychological testing (e.g. language, visual or hearing impairment)
5. Reside in an accessible proximity to the hospital for neuropsychological testing
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Minimum age
65
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. Pre-existing neurological or clinically evident neurovascular disease (e.g. stroke)
2. Dementia of any aetiology
3. Undergone general anaesthetic in past 6 months
4. Associated medical problems that may lead to significant complications and loss to follow-up
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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
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/03/2021
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Actual
7/04/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
76
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Accrual to date
5
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
15950
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St Vincent's Hospital (Melbourne) Ltd - Fitzroy
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Recruitment postcode(s) [1]
29434
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3065 - Fitzroy
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Funding & Sponsors
Funding source category [1]
304951
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Other Collaborative groups
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Name [1]
304951
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Australia and New Zealand College of Anaethetists
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Address [1]
304951
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ANZCA House,
630 St Kilda Road,
Melbourne, Victoria 3004,
Australia
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Country [1]
304951
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Australia
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Primary sponsor type
Hospital
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Name
St Vincent's Hospital
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Address
PO Box 2900
Fitzroy
VIC 3065
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Country
Australia
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Secondary sponsor category [1]
305308
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None
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Name [1]
305308
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Address [1]
305308
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Country [1]
305308
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
305360
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St Vincent's Hospital HREC
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Ethics committee address [1]
305360
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PO Box 2900 Fitzroy VIC 3065
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Ethics committee country [1]
305360
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Australia
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Date submitted for ethics approval [1]
305360
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10/01/2020
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Approval date [1]
305360
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17/02/2020
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Ethics approval number [1]
305360
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Summary
Brief summary
Recent preliminary findings suggest markers of neuronal damage (neurofilament light and tau) are associated with general anesthesia and surgery, which in turn may be associated with the clinical outcomes of delirium and postoperative cognitive dysfunction. Specifically, in a pilot study we observed that people undergoing cardiac surgery showed greater increases in plasma neurofilament light and tau than those undergoing non-cardiac surgery. The aim of this investigation is to compare the plasma levels of NFL and tau after cardiac compared to non-cardiac surgery and relate these levels to the subsequent neurocognitive outcomes in the postoperative period. Cognitive and memory testing will take place prior to surgery, at 7 days after surgery and at 3 months after surgery. Tests for delirium and collection of blood samples will also be conducted during the participants' time in hospital.
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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
100114
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A/Prof Brendan Silbert
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Address
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St Vincent's Hospital
PO Box 2900
Fitzroy
VIC 3065
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Country
100114
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Australia
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Phone
100114
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+61 0400 232 611
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Fax
100114
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Email
100114
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[email protected]
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Contact person for public queries
Name
100115
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Kelly Atkins
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Address
100115
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St Vincent's Hospital
PO Box 2900
Fitzroy
VIC 3065
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Country
100115
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Australia
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Phone
100115
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+61 03 9288 2072
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Fax
100115
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Email
100115
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[email protected]
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Contact person for scientific queries
Name
100116
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Kelly Atkins
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Address
100116
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St Vincent's Hospital
PO Box 2900
Fitzroy
VIC 3065
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Country
100116
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Australia
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Phone
100116
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+61 03 9231 2251
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Fax
100116
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Email
100116
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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)?
No
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No/undecided IPD sharing reason/comment
It is intended that the IPD will be made available for this trial but specific details have not yet been ascertained.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
6894
Study protocol
[email protected]
6895
Statistical analysis plan
[email protected]
6896
Informed consent form
[email protected]
6897
Clinical study report
[email protected]
6898
Ethical approval
[email protected]
6899
Analytic code
[email protected]
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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