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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

Moonesinghe, SR; Wong, DJN; Farmer, L; Shawyer, R; Myles, PS; Harris, SK; (2017) SNAP-2 EPICCS: the second Sprint National Anaesthesia Project—EPIdemiology of Critical Care after Surgery: protocol for an international observational cohort study. BMJ Open , 7 (9) , Article e017690. 10.1136/bmjopen-2017-017690. Green open access

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Abstract

INTRODUCTION: The 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 ANALYSIS: One-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 DISSEMINATION: The 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.

Type: Article
Title: SNAP-2 EPICCS: the second Sprint National Anaesthesia Project—EPIdemiology of Critical Care after Surgery: protocol for an international observational cohort study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjopen-2017-017690
Publisher version: https://doi.org/10.1136/bmjopen-2017-017690
Language: English
Additional information: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (https://creativecommons.org/licenses/by-nc/4.0/).
Keywords: anaesthetics, epiemiology, instrumental variable analysis, perioperative, surgery
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/10053977
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