Peri-operative MortalityCAMPNCT02208648
Coronary Assessment for Mortality Prediction
An observational study of Peri-operative Mortality and Coronary Artery Calcium, run by University Hospital Plymouth NHS Trust at 1 site in United Kingdom.
Trial summary
The study will investigate whether the presence of coronary artery calcium as demonstrated on pre-operative, thoracic staging Computed Tomography (CT) is an independent risk factor for 90 day mortality in patients undergoing major abdominal surgery. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Peri-operative Mortality, Coronary Artery Calcium
- How many people
- 90 participants
- Where
- 1 siteUnited Kingdom
- Study dates
- 31 Oct 2014to 11 Nov 2018
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Plymouth Hospital NHS Trust patients
Who may be able to join
- All adults ≥18yrs old
- Major abdominal surgery (See HRG Codes)
- Bowel Cancer
- Elective admission
Who cannot join
- <18 yrs old
- No suitable matched patient
- No CT Chest available
- Emergency admission
Trial locations and contacts
1 site in 1 country.
United Kingdom1 site
Plymouth Hospitals NHS Trust
Plymouth, Devon, PL6 8DH
About this study
The study will investigate whether the presence of coronary artery calcium as demonstrated on pre-operative, thoracic staging Computed Tomography (CT) is an independent risk factor for 90 day mortality in patients undergoing major abdominal surgery.
The study research question: Do higher levels of coronary calcification correlate to an increased risk of post-operative mortality in patients undergoing major abdominal surgery?
Read the detailed description
The study uses a retrospective observational study design.
Due to the nature of the subject of the study and its retrospective design no patient contact will be necessary and all imaging reviewed will have been acquired as part of their routine level of care.
Plan for the gathering of study data
A list of patients with the following surgical codes will be identified from the hospital surgical performance database to create retrospective dataset of 5 years' worth of cases (to December 2013). This date range may be extended to ensure an adequate sample size. :
Surgical codes (Healthcare Resource Groups (HRG) codes) to be included:
F31 Large Intestine - Complex Procedures F32 Large Intestine - Very Major Procedures F33 Large Intestine - Major Procedures with complications and comorbidities (w cc) F34 Large Intestine - Major Procedures without complications and comorbidities (w/o cc) F36 Large Intestinal Disorders >69 or w cc F37 Large Intestinal Disorders <70 w/o cc
F41 General Abdominal - Very Major or Major Procedures patients over 69 years of age (>69) or w cc F42 General Abdominal - Very Major or Major Procedures patients under 70 years of age (<70) w/o cc F46 General Abdominal Disorders >69 or w cc F47 General Abdominal Disorders <70 w/o cc
Cross-reference with Somerset Cancer Register and remove any who were not recognised as having bowel cancer.
This patient list will be cross-referenced with records of peri-operative mortality (within 90 days)
Propensity match each deceased patient to a patient who survived beyond 90 days. Our matching rules will be in descending order of importance :
- HRG code
- gender,
- cancer staging
- Age+/-5yrs.
- American Society of Anesthesiologists (ASA) Grade
Where there are multiple potential matches then this will be resolved by consultation between the research team members.
Pairs of CT scans (deceased plus matched control) will be procured from WebPACS (Web Picture Archival Communication System).
Scans will be anonymised and stored on a dedicated secure radiology research server.
Abbreviated Calcium scores will be generated for all patients in the trial by a trained radiologist using the calcium scoring method. Calcium burden will be recorded on a scale of 1-12 . The radiologist will be blinded to the group that the patient belongs to, to minimise bias.
Scans (deceased patients and matched controls) will be analysed in batches of 30 pairs. Radiologist (s) will be blinded to group allocation. Scans will not be "paired" at the time of reading.
Interim statistical analysis (of calcium scores) will be performed after each batch of scans.
- Conditions
- Peri-operative Mortality, Coronary Artery Calcium
- Keywords
- coronary calcification, Computed Tomography, Coronary artery calcium, calcium scores, post-operative mortality
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Deceased | Peri-operative mortality (within 90 days). Pairs of CT scans (deceased plus matched control) will be anonymised and stored on a secure server. Abbreviated Calcium scores will be generated for all patients in the trial by a trained radiologist using a calcium scoring method. The radiologist will be blinded to the group that the patient belongs to, to minimise bias. Scans (deceased patients and matched controls) will be analysed in batches of 30 pairs. Radiologist (s) will be blinded to group allocation. Scans will not be "paired" at the time of reading. | |
| Matched control | Patients who survived beyond 90 days peri-operatively. Pairs of CT scans (deceased plus matched control) will be anonymised and stored on a secure server. Abbreviated Calcium scores will be generated for all patients in the trial by a trained radiologist using a calcium scoring method. The radiologist will be blinded to the group that the patient belongs to, to minimise bias. Scans (deceased patients and matched controls) will be analysed in batches of 30 pairs. Radiologist (s) will be blinded to group allocation. Scans will not be "paired" at the time of reading. |
What is being measured
The primary outcome is the main question the study is designed to answer.
The primary outcome measure is an abbreviated calcium score
To investigate whether the presence and severity of coronary calcification identified on routine, pre-operative staging CT scans of the chest are an independent risk factor for patients undergoing major surgery. Techniques have now been validated where calcium scores can be estimated from routine CT scans of the chest (Shemesh et al. 2006).
Measured: 5 years
Secondary outcomes (1)
To assess the use of the calcium scoring technique in contrast enhanced studies.
Measured: 5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Aug 2014 (estimated)
- Study start31 Oct 2014
- Primary completion11 Nov 2018
- Study completion11 Nov 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Peri-operative MortalityStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Retrospective
- Enrolment
- 90 participants (actual)
Sponsor and investigators
- Lead sponsor
- University Hospital Plymouth NHS Trust
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Carl Roobottom, MBChB(Hons), Study chair, Plymouth Hospital NHS Trust
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02208648
- Sponsor's protocol ID
- 14/P/108
- Acronym
- CAMP
- Status last verified
- Sep 2019
- First submitted
- 4 Aug 2014
- Last updated
- 4 Sep 2019
- Results posted
- No
- Data monitoring committee
- No
Publications
Shemesh J, Henschke CI, Farooqi A, Yip R, Yankelevitz DF, Shaham D, Miettinen OS. Frequency of coronary artery calcification on low-dose computed tomography screening for lung cancer. Clin Imaging. 2006 May-Jun;30(3):181-5. doi: 10.1016/j.clinimag.2005.11.002.
PubMed 16632153
Study at a glance
From the registry record, last updated by the sponsor on 4 Sep 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Coronary Assessment for Mortality Prediction
- ClinicalTrials.gov ID
- NCT02208648
- Acronym / sponsor ID
- CAMP / 14/P/108
- Conditions
- Peri-operative Mortality, Coronary Artery Calcium
- Keywords
- coronary calcification, Computed Tomography, Coronary artery calcium, calcium scores, post-operative mortality
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 90 participants (actual)
- Lead sponsor
- University Hospital Plymouth NHS TrustUniversity, hospital or other
- Study start
- 31 Oct 2014 (actual)
- Primary completion
- 11 Nov 2018 (actual)
- Study completion
- 11 Nov 2018 (actual)
- First posted
- 5 Aug 2014 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The study will investigate whether the presence of coronary artery calcium as demonstrated on pre-operative, thoracic staging Computed Tomography (CT) is an independent risk factor for 90 day mortality in patients undergoing major abdominal surgery.
The study research question: Do higher levels of coronary calcification correlate to an increased risk of post-operative mortality in patients undergoing major abdominal surgery?
Detailed description
The study uses a retrospective observational study design.
Due to the nature of the subject of the study and its retrospective design no patient contact will be necessary and all imaging reviewed will have been acquired as part of their routine level of care.
Plan for the gathering of study data
A list of patients with the following surgical codes will be identified from the hospital surgical performance database to create retrospective dataset of 5 years' worth of cases (to December 2013). This date range may be extended to ensure an adequate sample size. :
Surgical codes (Healthcare Resource Groups (HRG) codes) to be included:
F31 Large Intestine - Complex Procedures F32 Large Intestine - Very Major Procedures F33 Large Intestine - Major Procedures with complications and comorbidities (w cc) F34 Large Intestine - Major Procedures without complications and comorbidities (w/o cc) F36 Large Intestinal Disorders >69 or w cc F37 Large Intestinal Disorders <70 w/o cc
F41 General Abdominal - Very Major or Major Procedures patients over 69 years of age (>69) or w cc F42 General Abdominal - Very Major or Major Procedures patients under 70 years of age (<70) w/o cc F46 General Abdominal Disorders >69 or w cc F47 General Abdominal Disorders <70 w/o cc
Cross-reference with Somerset Cancer Register and remove any who were not recognised as having bowel cancer.
This patient list will be cross-referenced with records of peri-operative mortality (within 90 days)
Propensity match each deceased patient to a patient who survived beyond 90 days. Our matching rules will be in descending order of importance :
- HRG code
- gender,
- cancer staging
- Age+/-5yrs.
- American Society of Anesthesiologists (ASA) Grade
Where there are multiple potential matches then this will be resolved by consultation between the research team members.
Pairs of CT scans (deceased plus matched control) will be procured from WebPACS (Web Picture Archival Communication System).
Scans will be anonymised and stored on a dedicated secure radiology research server.
Abbreviated Calcium scores will be generated for all patients in the trial by a trained radiologist using the calcium scoring method. Calcium burden will be recorded on a scale of 1-12 . The radiologist will be blinded to the group that the patient belongs to, to minimise bias.
Scans (deceased patients and matched controls) will be analysed in batches of 30 pairs. Radiologist (s) will be blinded to group allocation. Scans will not be "paired" at the time of reading.
Interim statistical analysis (of calcium scores) will be performed after each batch of scans.
Study design
- Observational model
- Cohort
- Time perspective
- Retrospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Deceased | – | –Peri-operative mortality (within 90 days). Pairs of CT scans (deceased plus matched control) will be anonymised and stored on a secure server. Abbreviated Calcium scores will be generated for all patients in the trial by a trained radiologist using a calcium scoring method. The radiologist will be blinded to the group that the patient belongs to, to minimise bias. Scans (deceased patients and matched controls) will be analysed in batches of 30 pairs. Radiologist (s) will be blinded to group allocation. Scans will not be "paired" at the time of reading. |
| Matched control | – | –Patients who survived beyond 90 days peri-operatively. Pairs of CT scans (deceased plus matched control) will be anonymised and stored on a secure server. Abbreviated Calcium scores will be generated for all patients in the trial by a trained radiologist using a calcium scoring method. The radiologist will be blinded to the group that the patient belongs to, to minimise bias. Scans (deceased patients and matched controls) will be analysed in batches of 30 pairs. Radiologist (s) will be blinded to group allocation. Scans will not be "paired" at the time of reading. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Plymouth Hospital NHS Trust patients
Key inclusion criteria (4 listed)
- All adults ≥18yrs old
- Major abdominal surgery (See HRG Codes)
- Bowel Cancer
- Elective admission
Key exclusion criteria (4 listed)
- <18 yrs old
- No suitable matched patient
- No CT Chest available
- Emergency admission
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
The primary outcome measure is an abbreviated calcium score
Time frame: 5 years
To investigate whether the presence and severity of coronary calcification identified on routine, pre-operative staging CT scans of the chest are an independent risk factor for patients undergoing major surgery. Techniques have now been validated where calcium scores can be estimated from routine CT scans of the chest (Shemesh et al. 2006).
1 secondary outcome
To assess the use of the calcium scoring technique in contrast enhanced studies.
Time frame: 5 years
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Sep 2019.
- Background: PubMed 16632153Shemesh J, Henschke CI, Farooqi A, Yip R, Yankelevitz DF, Shaham D, Miettinen OS. Frequency of coronary artery calcification on low-dose computed tomography screening for lung cancer. Clin Imaging. 2006 May-Jun;30(3):181-5. doi: 10.1016/j.clinimag.2005.11.002.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Carl Roobottom, MBChB(Hons) study chair
Plymouth Hospital NHS Trust
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Peri-operative Mortality and Coronary Artery Calcium, run by University Hospital Plymouth NHS Trust at 1 site in United Kingdom.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 4 Sep 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The primary outcome measure is an abbreviated calcium score (time frame: 5 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02208648, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Sep 2019.