General SurgeryEASENCT02233153
Elder-friendly Approaches to the Surgical Environment (EASE) Study
An observational study of General Surgery, run by University of Alberta at 2 sites in Canada.
Trial summary
The aim of this study is to examine the impact implementing an elder-friendly surgical unit has on post-operative complications, mortality and quality of life for patients ≥ 65 years old who have undergone emergency surgical care. Read more about this study
- Who is it for?
- Ages 65 years and older
- Conditions the study is for
- General Surgery
- What is being tested?
- Elder-Friendly Surgical Unit
- How many people
- 723 participants
- Where
- 2 sitesCanada
- Study dates
- Apr 2014to Dec 2017
- 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 65 years and older
- All sexes
- No healthy volunteers
- Older adult
Study population: All patients > 65 years old admitted and received acute abdominal surgery
Who may be able to join
- All patients > 65 years old admitted for Acute care and Emergency Surgery
- Received acute abdominal surgery
Who cannot join
- Elective general surgery cases
- Nursing home resident requiring full nursing care [dependency in 3 or more activities of daily living ]
- Palliative surgery [surgery with the primary intention of improving quality of life or relieving symptoms caused by advancing non-curative disease]
- Multi-system trauma
- Patients from out of province or transferred from another inpatient service or hospital
Trial locations and contacts
2 sites in 1 country.
Canada2 sites
Foothills Medical Center, Acute Care Emergency Surgical Services
Calgary, Alberta
University of Alberta Hospital, Acute Care and Emergency Surgery Service
Edmonton, Alberta
About this study
Official title: Elder-friendly Approaches to the Surgical Environment - Implementation of an Elder Friendly Surgical Unit
The aim of this study is to examine the impact implementing an elder-friendly surgical unit has on post-operative complications, mortality and quality of life for patients ≥ 65 years old who have undergone emergency surgical care.
Read the detailed description
The investigators hypothesize that the elder-friendly surgical unit will reduce in-hospital complications and mortality in a cost-effective manner, for this at risk population.
Specific elder-friendly interventions include:
- Locate all elderly surgical patients on one nursing unit
- Interdisciplinary team-based care
- Elder-friendly evidence-informed practices including: comfort rounds with early mobilization, delirium prevention/management, optimal nutrition and prevention of post-operative complications
- Early and interdisciplinary discharge management
This is a prospective, before-after study with a concurrent control group. Four senior patient groups will be followed:
- Conditions
- General Surgery
- Being tested
- Elder-Friendly Surgical Unit
- Keywords
- Senior, Elderly, Acute Care, Emergency Surgery
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Elder-Friendly Surgical UnitOther
| Study group | Role | What they receive |
|---|---|---|
| Pre-Elder Friendly Surgical Intervention Group | Elder Acute Care and Emergency Surgery patients | |
| Post-Elder Friendly Surgical Intervention Group | Elder Acute Care and Emergency Surgery patients Receives: Other: Elder-Friendly Surgical Unit | |
| Pre-Elder Friendly Surgical Control Group | Elder Acute Care and Emergency Surgery patients | |
| Post-Elder Friendly Surgical Control Group | Not described |
What is being measured
The primary outcome is the main question the study is designed to answer.
Post-Operative complications
Includes a) intensive care unit admission (includes respiratory failure, cardiac arrest or septic shock), b) vascular complications (myocardial infarction, stroke, deep venous thrombosis, pulmonary embolism), c) serious infections (pneumonia, intra-abdominal abscess, urinary tract infection, deep wound infection or infected decubitus ulcer) or d) protracted delirium (≥48 hours)
Measured: During initial in-hospital stay (0-12 weeks on average)
Death
Measured: During initial in-hospital stay (0-12 weeks on average)
Secondary outcomes (2)
Post-discharge complications or health-events requiring re-admission
Measured: Within 30 days post-discharge
Cost per quality-adjusted life year
Both direct and indirect study participant costs
Measured: 6 months post-discharge
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Sep 2014 (estimated)
- Study startApr 2014
- Primary completionMay 2017
- Study completionDec 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (8)Papers the sponsor has linked to this study.
- Other trials for General SurgeryStudies 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
- Other
- Time perspective
- Prospective
- Enrolment
- 723 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Alberta
- Sponsor type
- University, hospital or other
- Collaborators
- Alberta Innovates Health Solutions
- Responsible party
- Principal investigator, Rachel Khadaroo, University of Alberta
- Investigators
- Rachel G Khadaroo, MD, Principal investigator, University of Alberta
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02233153
- Sponsor's protocol ID
- Pro00047180
- Acronym
- EASE
- Status last verified
- Oct 2018
- First submitted
- 22 Aug 2014
- Last updated
- 19 Oct 2018
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Hanson HM, Warkentin L, Wilson R, Sandhu N, Slaughter SE, Khadaroo RG. Facilitators and barriers of change toward an elder-friendly surgical environment: perspectives of clinician stakeholder groups. BMC Health Serv Res. 2017 Aug 24;17(1):596. doi: 10.1186/s12913-017-2481-z.
PubMed 28836979Khadaroo RG, Padwal RS, Wagg AS, Clement F, Warkentin LM, Holroyd-Leduc J. Optimizing senior's surgical care - Elder-friendly Approaches to the Surgical Environment (EASE) study: rationale and objectives. BMC Health Serv Res. 2015 Aug 21;15:338. doi: 10.1186/s12913-015-1001-2.
PubMed 26293153Li Y, Pederson JL, Churchill TA, Wagg AS, Holroyd-Leduc JM, Alagiakrishnan K, Padwal RS, Khadaroo RG. Impact of frailty on outcomes after discharge in older surgical patients: a prospective cohort study. CMAJ. 2018 Feb 20;190(7):E184-E190. doi: 10.1503/cmaj.161403.
PubMed 29565018Eamer GJ, Clement F, Pederson JL, Churchill TA, Khadaroo RG. Analysis of postdischarge costs following emergent general surgery in elderly patients. Can J Surg. 2018 Feb;61(1):19-27. doi: 10.1503/cjs.002617. Epub 2017 Dec 1.
PubMed 29368673McComb A, Warkentin LM, McNeely ML, Khadaroo RG. Development of a reconditioning program for elderly abdominal surgery patients: the Elder-friendly Approaches to the Surgical Environment-BEdside reconditioning for Functional ImprovemenTs (EASE-BE FIT) pilot study. World J Emerg Surg. 2018 May 21;13:21. doi: 10.1186/s13017-018-0180-7. eCollection 2018.
PubMed 29942346Pederson JL, Padwal RS, Warkentin LM, Holroyd-Leduc JM, Wagg A, Khadaroo RG. The impact of delayed mobilization on post-discharge outcomes after emergency abdominal surgery: A prospective cohort study in older patients. PLoS One. 2020 Nov 6;15(11):e0241554. doi: 10.1371/journal.pone.0241554. eCollection 2020.
PubMed 33156849Khadaroo RG, Warkentin LM, Wagg AS, Padwal RS, Clement F, Wang X, Buie WD, Holroyd-Leduc J. Clinical Effectiveness of the Elder-Friendly Approaches to the Surgical Environment Initiative in Emergency General Surgery. JAMA Surg. 2020 Apr 1;155(4):e196021. doi: 10.1001/jamasurg.2019.6021. Epub 2020 Apr 15.
PubMed 32049271Eamer GJ, Clement F, Holroyd-Leduc J, Wagg A, Padwal R, Khadaroo RG. Frailty predicts increased costs in emergent general surgery patients: A prospective cohort cost analysis. Surgery. 2019 Jul;166(1):82-87. doi: 10.1016/j.surg.2019.01.033. Epub 2019 Apr 27.
PubMed 31036332
Study at a glance
From the registry record, last updated by the sponsor on 19 Oct 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Elder-friendly Approaches to the Surgical Environment - Implementation of an Elder Friendly Surgical Unit
- ClinicalTrials.gov ID
- NCT02233153
- Acronym / sponsor ID
- EASE / Pro00047180
- Conditions
- General Surgery
- Keywords
- Senior, Elderly, Acute Care, Emergency Surgery
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 723 participants (actual)
- Lead sponsor
- University of AlbertaUniversity, hospital or other
- Collaborators
- Alberta Innovates Health Solutions
- Study start
- Apr 2014 (actual)
- Primary completion
- May 2017 (actual)
- Study completion
- Dec 2017 (actual)
- First posted
- 8 Sep 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 aim of this study is to examine the impact implementing an elder-friendly surgical unit has on post-operative complications, mortality and quality of life for patients ≥ 65 years old who have undergone emergency surgical care.
Detailed description
The investigators hypothesize that the elder-friendly surgical unit will reduce in-hospital complications and mortality in a cost-effective manner, for this at risk population.
Specific elder-friendly interventions include:
- Locate all elderly surgical patients on one nursing unit
- Interdisciplinary team-based care
- Elder-friendly evidence-informed practices including: comfort rounds with early mobilization, delirium prevention/management, optimal nutrition and prevention of post-operative complications
- Early and interdisciplinary discharge management
This is a prospective, before-after study with a concurrent control group. Four senior patient groups will be followed:
Study design
- Observational model
- Other
- Time perspective
- Prospective
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Pre-Elder Friendly Surgical Intervention Group | – | –Elder Acute Care and Emergency Surgery patients |
| Post-Elder Friendly Surgical Intervention Group | – | Other: Elder-Friendly Surgical UnitElder Acute Care and Emergency Surgery patients |
| Pre-Elder Friendly Surgical Control Group | – | –Elder Acute Care and Emergency Surgery patients |
| Post-Elder Friendly Surgical Control Group | – | – |
Who may qualify
- Ages
- 65 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Older adult
- Study population
- All patients > 65 years old admitted and received acute abdominal surgery
Key inclusion criteria (2 listed)
- All patients > 65 years old admitted for Acute care and Emergency Surgery
- Received acute abdominal surgery
Key exclusion criteria (5 listed)
- Elective general surgery cases
- Nursing home resident requiring full nursing care [dependency in 3 or more activities of daily living ]
- Palliative surgery [surgery with the primary intention of improving quality of life or relieving symptoms caused by advancing non-curative disease]
- Multi-system trauma
- Patients from out of province or transferred from another inpatient service or hospital
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Elder-Friendly Surgical Unit | Other | Post-Elder Friendly Surgical Intervention Group |
Primary outcome
Post-Operative complications
Time frame: During initial in-hospital stay (0-12 weeks on average)
Includes a) intensive care unit admission (includes respiratory failure, cardiac arrest or septic shock), b) vascular complications (myocardial infarction, stroke, deep venous thrombosis, pulmonary embolism), c) serious infections (pneumonia, intra-abdominal abscess, urinary tract infection, deep wound infection or infected decubitus ulcer) or d) protracted delirium (≥48 hours)
Death
Time frame: During initial in-hospital stay (0-12 weeks on average)
2 secondary outcomes
Post-discharge complications or health-events requiring re-admission
Time frame: Within 30 days post-discharge
Cost per quality-adjusted life year
Time frame: 6 months post-discharge
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 19 Oct 2018.
- Background: PubMed 28836979Hanson HM, Warkentin L, Wilson R, Sandhu N, Slaughter SE, Khadaroo RG. Facilitators and barriers of change toward an elder-friendly surgical environment: perspectives of clinician stakeholder groups. BMC Health Serv Res. 2017 Aug 24;17(1):596. doi: 10.1186/s12913-017-2481-z.
- Background: PubMed 26293153Khadaroo RG, Padwal RS, Wagg AS, Clement F, Warkentin LM, Holroyd-Leduc J. Optimizing senior's surgical care - Elder-friendly Approaches to the Surgical Environment (EASE) study: rationale and objectives. BMC Health Serv Res. 2015 Aug 21;15:338. doi: 10.1186/s12913-015-1001-2.
- Results publication: PubMed 29565018Li Y, Pederson JL, Churchill TA, Wagg AS, Holroyd-Leduc JM, Alagiakrishnan K, Padwal RS, Khadaroo RG. Impact of frailty on outcomes after discharge in older surgical patients: a prospective cohort study. CMAJ. 2018 Feb 20;190(7):E184-E190. doi: 10.1503/cmaj.161403.
- Results publication: PubMed 29368673Eamer GJ, Clement F, Pederson JL, Churchill TA, Khadaroo RG. Analysis of postdischarge costs following emergent general surgery in elderly patients. Can J Surg. 2018 Feb;61(1):19-27. doi: 10.1503/cjs.002617. Epub 2017 Dec 1.
- Results publication: PubMed 29942346McComb A, Warkentin LM, McNeely ML, Khadaroo RG. Development of a reconditioning program for elderly abdominal surgery patients: the Elder-friendly Approaches to the Surgical Environment-BEdside reconditioning for Functional ImprovemenTs (EASE-BE FIT) pilot study. World J Emerg Surg. 2018 May 21;13:21. doi: 10.1186/s13017-018-0180-7. eCollection 2018.
- Derived from this study: PubMed 33156849Pederson JL, Padwal RS, Warkentin LM, Holroyd-Leduc JM, Wagg A, Khadaroo RG. The impact of delayed mobilization on post-discharge outcomes after emergency abdominal surgery: A prospective cohort study in older patients. PLoS One. 2020 Nov 6;15(11):e0241554. doi: 10.1371/journal.pone.0241554. eCollection 2020.
- Derived from this study: PubMed 32049271Khadaroo RG, Warkentin LM, Wagg AS, Padwal RS, Clement F, Wang X, Buie WD, Holroyd-Leduc J. Clinical Effectiveness of the Elder-Friendly Approaches to the Surgical Environment Initiative in Emergency General Surgery. JAMA Surg. 2020 Apr 1;155(4):e196021. doi: 10.1001/jamasurg.2019.6021. Epub 2020 Apr 15.
- Derived from this study: PubMed 31036332Eamer GJ, Clement F, Holroyd-Leduc J, Wagg A, Padwal R, Khadaroo RG. Frailty predicts increased costs in emergent general surgery patients: A prospective cohort cost analysis. Surgery. 2019 Jul;166(1):82-87. doi: 10.1016/j.surg.2019.01.033. Epub 2019 Apr 27.
- Individual participant dataSharing planned: No
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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.
Rachel G Khadaroo, MD principal investigator
University of Alberta
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of General Surgery, run by University of Alberta at 2 sites in Canada.
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 2 inclusion and 5 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 19 Oct 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Canada. 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?
Post-Operative complications (time frame: During initial in-hospital stay (0-12 weeks on average)). The study lists 2 primary outcomes in all. 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 NCT02233153, which also lists 8 linked publications.
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 19 Oct 2018.