Core Outcome Measures for Perioperative and Anaesthetic Care (COMPAC): a modified Delphi process to develop a core outcome set for trials in perioperative care and anaesthesia

Boney, Oliver; Moonesinghe, Ramani; Myles, Paul S.; Grocott, Michael P.W.; Bartoszko, Justyna; Beattie, W. Scott; Bellomo, Rinaldo; Buggy, Donal J.; Cabrini, Luca; Canet, Jaume; Cook, Tim; Cooper, D. Jamie; Corcoran, Tomás; Devereaux, P.J.; Eckenhoff, Rod; Evered, Lis; Gan, T.J.; Gin, Tony; Grocott, Hilary P.; Haller, Guy; Howell, Simon; Jayarajah, Mohindas; Kalkman, Cor J.; Karkouti, Keyvan; Kavanagh, Bianca E; Klein, Andrew C.; Landoni, Giovani; Leslie, Kate; McIlroy, David R.; Mazer, C. David; Møller, Ann Merete; Mythen, Monty; Neuman, Mark D.; Pearse, Rupert M; Peyton, Phil; Prowle, John R.; Richards, Toby; Scott, David A.; Sessler, D I; Shaw, Andrew; Short, Tim; Shulman, Mark; Silbert, Brendan; Singer, Mervyn; Sneyd, J. R.; Story, David A; Dijk, Diederik van; Klei, Wilton van

doi:10.1016/j.bja.2021.09.027

Cited by 40 publications

(41 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The characteristics of included studies are summarized in Table 1. Eight involving high-quality nursing services for the patients during the anesthesia recovery period were included [10][11][12][13][14][15][16][17]. All the experimental groups were treated with high-quality nursing [10][11][12][13][14][15][16][17].…”

Section: Characteristics Of Includedmentioning

confidence: 99%

“…Meta-analysis identifies the risk of bias in randomized trials included in this study (Figure 2). We performed the randomization based on the computer-aided random list or using a randomly generated pattern of numbers within most of the trials [10][11][12][13][14][15][16][17]. The low risk of incomplete outcome data and selection of outcome reports were utilized to characterize the randomized trials taken in this research.…”

Section: Characteristics Of Includedmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of High-Quality Nursing Service for the Patients during the Anesthesia Recovery Period: A Meta-Analysis

Wang

Pan

et al. 2022

Applied Bionics and Biomechanics

View full text Add to dashboard Cite

Background. To investigate the efficacy of high-quality nursing service for the patients during the anesthesia recovery period. Methods. We used the National Library of Medicine (PubMed), Cochrane Library of Excerpta Medica Database (EMBASE), China National Knowledge Infrastructure (CNKI), Wanfang, and very important person (VIP) databases for conducting a systematic literature study. We employed the fixed-effects model for evaluating the standardized mean differences (SMDs) with 95% confidence intervals (CIs). The sensitivity and publication bias were estimated for determining the efficacy of high-quality nursing services during the recovery period of anesthesia. Results. In our study, the result showed that the efficiency of recovery time of spontaneous respiration was significantly improved in the experimental group ( SMD = − 1.48 , 95 % CI = − 1.62 , − 1.34 ). In this analysis, the extubation time of the experimental group was lower than that of the control group. In control group [ WMD = − 15.54 , 95% CI (-21.24, -9.83), P < 0.00001 ], the improvement of extubation time was more obvious on high-quality nursing. Moreover, the incidence of agitation in the experimental group was lower than that of the control group, and the score of nursing satisfaction was higher than that in the control group ( P = 0.01 ). The funnel plots identified no publication bias during the identification of efficacy. Conclusions. The high-quality nursing care for patients during the resuscitation period can shorten the recovery time of their self-consciousness and self-breathing, reduce the occurrence rate of restlessness, improve patients’ anxiety and depression, reduce complications, and play a certain clinical application effect.

show abstract

Section: Characteristics Of Includedmentioning

confidence: 99%

Section: Characteristics Of Includedmentioning

confidence: 99%

Efficacy of High-Quality Nursing Service for the Patients during the Anesthesia Recovery Period: A Meta-Analysis

Wang

Pan

et al. 2022

Applied Bionics and Biomechanics

View full text Add to dashboard Cite

show abstract

“…Recommendations for Core Outcomes for Measures for Perioperative and Anaesthetic Care to guide outcome selection in future studies was recently published. 13 It was not available when we first developed this project but will certainly look to it in the future.…”

Section: Discussionmentioning

confidence: 99%

Quality improvement initiative: how the setting up of an anaesthesia consultant-led perioperative outreach service addressed anaesthesia-specific issues to improve anaesthesia consult and surgery timings for hip fracture patients

2022

View full text Add to dashboard Cite

BackgroundSurgery is recommended within 48 hours of hip fractures for better perioperative outcomes. Yet, such targets still commonly remain a challenge. Our institution is no exception.As part of a hospital-wide initiative, our anaesthesia department focused on improving perioperative processes with aims to reduce the time to first anaesthesia consult and surgery for hip fracture patients. Acknowledging multiple causes for surgical delay, we decided first to address anaesthesia-specific factors—(a) first anaesthetist contact usually happens after surgery is offered which leaves a short runway for preoptimisation, (b) this is compounded by varying degrees of anaesthetist involvement for follow-up thereafter. (c) There is a need to calibrate our perioperative care standards and (d) enforce more consistent auditing in quality assurance. This project was conducted in a 1000-bed hospital serving eastern Singapore.InterventionWe created an integrated anaesthesia consultant-led outreach service for hip fracture patients, based on a perioperative workflow system to provide proactive anaesthetist consults within 24 hours of admission in advance of surgical decision. This was streamlined with a coordinated follow-up system for preoptimisation until surgery.MethodsOur quality improvement project applied the iterative Plan-Do-Study-Act model from pilot to sustainability stage. We collected data at baseline followed by 6-monthly audits from electronic databases.Primary outcomes measured were time to first anaesthesia consult and surgery. Secondary outcomes included rate of critical care reviews and admission, mortality rate, length of stay and time to nerve blocks.ResultsPost implementation, our service reviewed >600 hip fracture patients. Median time to anaesthesia consult reduced significantly from 35.3 hours (2019) to 21.5 hours (2021) (p=0.029). Median time to surgery was reduced from 61.5 hours (2019) to 50 hours (2021) (p=0.897) with a 13.6% increase in patients operated <48 hours. Critical care admissions, 6-monthly and 12-monthly mortality rates and time to nerve block were reduced with a greater percentage of patients discharged within 10 days.ConclusionOur project focused on improving anaesthesia perioperative processes to address surgical delays in hip fracture patients. Our consultant-led anaesthesia service ensured that proactive anaesthesia care was delivered to provide sufficient time for preoptimisation with greater standardisation to follow-up, better communication and quality assurance.

show abstract

“…For patients who were alive at 90 days, DAOH was calculated by subtracting their total LOS across all admissions across the 90-day follow-up period. Those patients who died within the 90-day period were assigned zero DAOH [24]. The study's sample size for each condition was projected to be sufficient to assess overall differences between the comparison groups in the mean DAOH of at least 3 days, with 80% power, and 95% levels of statistical significance [19].…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of emergency surgery for five common acute conditions: an instrumental variable analysis of a national routine database

et al. 2022

View full text Add to dashboard Cite

The effectiveness of emergency surgery vs. non-emergency surgery strategies for emergency admissions with acute appendicitis, gallstone disease, diverticular disease, abdominal wall hernia or intestinal obstruction is unknown. Data on emergency admissions for adult patients from 2010 to 2019 at 175 acute National Health Service hospitals in England were extracted from the Hospital Episode Statistics database. Cohort sizes were: 268,144 (appendicitis); 240,977 (gallstone disease); 138,869 (diverticular disease); 106,432 (hernia); and 133,073 (intestinal obstruction). The primary outcome was number of days alive and out of hospital at 90 days. The effectiveness of emergency surgery vs. non-emergency surgery strategies was estimated using an instrumental variable design and is reported for the cohort and pre-specified sub-groups (age, sex, number of comorbidities and frailty level). Average days alive and out of hospital at 90 days for all five cohorts were similar, with the following mean differences (95%CI) for emergency surgery minus non-emergency surgery after adjusting for confounding: À0.73 days (À2.10-0.64) for appendicitis; 0.60 (À0.10-1.30) for gallstone disease; À2.66 (À15.7-10.4) for diverticular disease; À0.07 (À2.40-2.25) for hernia; and 3.32 (À3.13-9.76) for intestinal obstruction. For patients with 'severe frailty', mean differences (95%CI) in days alive and out of hospital for emergency surgery were lower than for non-emergency surgery strategies: À21.0 (À27.4 to À14.6) for appendicitis; À5.72 (À11.3 to À0.2) for gallstone disease, À38.9 (À63.3 to À14.6) for diverticular disease; À19.5 (À26.6 to À12.3) for hernia; and À 34.5 (À46.7 to À22.4) for intestinal obstruction. For patients without frailty, the mean differences (95%CI) in days alive and out of hospital were: À0.18 (À1.56-1.20) for appendicitis; 0.93 (0.48-1.39) for gallstone disease; 5.35 (À2.56-13.28) for diverticular disease; 2.26 (0.37-4.15) for hernia; and 18.2 (14.8-22.47) for intestinal obstruction. Emergency surgery and non-emergency surgery strategies led to similar average days alive and out of hospital at 90 days for five acute conditions. The comparative effectiveness of emergency surgery and non-emergency surgery strategies for these conditions may be modified by patient factors.

show abstract

Core Outcome Measures for Perioperative and Anaesthetic Care (COMPAC): a modified Delphi process to develop a core outcome set for trials in perioperative care and anaesthesia

Cited by 40 publications

References 48 publications

Efficacy of High-Quality Nursing Service for the Patients during the Anesthesia Recovery Period: A Meta-Analysis

Efficacy of High-Quality Nursing Service for the Patients during the Anesthesia Recovery Period: A Meta-Analysis

Quality improvement initiative: how the setting up of an anaesthesia consultant-led perioperative outreach service addressed anaesthesia-specific issues to improve anaesthesia consult and surgery timings for hip fracture patients

Effectiveness of emergency surgery for five common acute conditions: an instrumental variable analysis of a national routine database

Contact Info

Product

Resources

About