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SNAP-2 EPICCS: the second Sprint National Anaesthesia Project—EPIdemiology of Critical Care after Surgery: protocol for an international observational cohort study
- Source :
- BMJ Open
- Publication Year :
- 2017
- Publisher :
- BMJ, 2017.
-
Abstract
- IntroductionThe admission of high-risk patients to critical care after surgery is a recommended standard of care. Nevertheless, poor compliance against this recommendation has been repeatedly demonstrated in large epidemiological studies. It is unclear whether this is due to reasons of capacity, equipoise, poor quality clinical care or because hospitals are working creatively to create capacity for augmented care on normal surgical wards. The EPIdemiology of Critical Care after Surgery study aims to address these uncertainties.Methods and analysisOne-week observational cohort study in the UK and Australasia. All patients undergoing inpatient (overnight stay) surgery will be included. All will have prospective data collection on risk factors, surgical procedure and postoperative outcomes including the primary outcome of morbidity (measured using the Postoperative Morbidity Survey on day 7 after surgery) and secondary outcomes including length of stay and mortality. Data will also be collected on critical care referral and admission, surgical cancellations and critical care occupancy. The epidemiology of patient characteristics, processes and outcomes will be described. Inferential techniques (multilevel multivariable regression, propensity score matching and instrumental variable analysis) will be used to evaluate the relationship between critical care admission and postoperative outcome.Ethics and disseminationThe study has received ethical approval from the National Research Ethics Service in the UK and equivalent in Australasia. The collection of patient identifiable data without prior consent has been approved by the Confidentiality Advisory Group (England and Wales) and the Public Privacy and Patient Benefit Panel (Scotland). In these countries, patient identifiable data will be used to link prospectively collected data with national registers of death and inpatient administrative data. The study findings will be disseminated using a multimedia approach with the support of our lay collaborators, to patients, public, policy-makers, clinical and academic audiences.
- Subjects :
- medicine.medical_specialty
Critical Care
Referral
epiemiology
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
030202 anesthesiology
Epidemiology
Protocol
medicine
Humans
Confidentiality
Prospective Studies
030212 general & internal medicine
perioperative
Propensity Score
Quality of Health Care
Protocol (science)
Research ethics
Australasia
business.industry
Data Collection
General Medicine
Perioperative
United Kingdom
anaesthetics
Surgery
Hospitalization
Research Design
Surgical Procedures, Operative
instrumental variable analysis
Multivariate Analysis
Propensity score matching
Regression Analysis
Morbidity
business
Cohort study
Subjects
Details
- ISSN :
- 20446055
- Volume :
- 7
- Database :
- OpenAIRE
- Journal :
- BMJ Open
- Accession number :
- edsair.doi.dedup.....2f10a5dcc7b9b93fe7b875669b3700db