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Trial registered on ANZCTR
Registration number
ACTRN12619001336178
Ethics application status
Approved
Date submitted
19/08/2019
Date registered
30/09/2019
Date last updated
21/12/2021
Date data sharing statement initially provided
30/09/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
Using C-reactive protein (CRP) for earlier detection of Infectious complications following Colorectal Surgery
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Scientific title
Using C-reactive protein (CRP) for earlier detection of Infectious complications following Colorectal Surgery
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Secondary ID [1]
299056
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Colorectal Cancer
314080
0
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Diverticular disease
314081
0
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Inflammatory Bowel Disease
314082
0
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Condition category
Condition code
Surgery
312459
312459
0
0
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Other surgery
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Cancer
312711
312711
0
0
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Bowel - Back passage (rectum) or large bowel (colon)
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Oral and Gastrointestinal
312712
312712
0
0
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Inflammatory bowel disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Prospective, non-randomised, non-blinded clinical trial comparing two patient groups over two consecutive time periods.
Group 1 (Standard Care) – Patients have CRP levels measured on postoperative days 3 to 5 via a simple peripheral venous blood test which will be collected by a phlebotomist or doctor from the surgical team. A septic screen is performed based on the patients clinical status (vital signs, examination findings) rather than CRP alone.
Group 2 (CRP protocol group) - Patients have CRP levels measured on postoperative days 3 to 5 as for Group 1. If the CRP value is above certain thresholds on these days (>170mg/L on day 3, >125mg/L on day 4, or >50mg/L increase between day 3 and 4, or between day 4 and 5), a 'septic screen' will be performed on the same day to look for a source of infection regardless of normal vital signs or examination findings. This will include:
- CT scan of the abdomen and pelvis
- Chest x-ray
- Cultures of urine, wound and blood/central lines
Fidelity of this data will be ensured through prospective collection of CRP data and complications and further assessed through audit of electronic records and hospital notes at the end of the study.
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Intervention code [1]
315327
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Diagnosis / Prognosis
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Comparator / control treatment
The interventional group will be compared to standard care where a septic screen is performed based on clinical status of the patient rather than routine blood tests. This is assessed by doctors on the surgical team and based on the patient's symptoms, vital signs, and physical examination.
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Control group
Active
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Outcomes
Primary outcome [1]
321105
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Infectious complications (e.g. wound infection, chest infection, urinary tract infection, anastomotic leak, abdominal collection).
These will be assessed by the surgical team as part of routine clinical care and postoperative follow-up. They will be prospectively recorded by the principal investigator and research team.
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Assessment method [1]
321105
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Timepoint [1]
321105
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Assessed daily while in hospital and then weekly once discharged until 30 days post surgery.
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Secondary outcome [1]
374003
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Re-intervention - composite of return to operating theatre or requiring radiological drainage.
These will be assessed by the surgical team as part of routine clinical care and postoperative follow-up. They will be prospectively recorded by the principal investigator and research team.
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Assessment method [1]
374003
0
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Timepoint [1]
374003
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Till 30 days after surgery
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Secondary outcome [2]
374004
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Length of hospital stay assessed using medical records.
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Assessment method [2]
374004
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Timepoint [2]
374004
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Till 30 days after surgery
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Secondary outcome [3]
374005
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Readmission assessed using medical records.
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Assessment method [3]
374005
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Timepoint [3]
374005
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Till 30 days after surgery
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Eligibility
Key inclusion criteria
Adult patients (18 years and older) undergoing elective colonic or rectal resection
with a primary anastomosis (with or without a defunctioning stoma) or reversal of Hartmann’s procedure at Lyell McEwin Hospital
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients undergoing an emergency operation, no bowel anastomosis, severe renal
impairment (CrCl <30ml/min) or allergy to contrast precluding a contrast-enhanced CT scan
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/10/2019
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Actual
1/03/2019
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Date of last participant enrolment
Anticipated
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Actual
10/08/2020
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Date of last data collection
Anticipated
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Actual
10/09/2020
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Sample size
Target
120
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Accrual to date
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Final
180
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Recruitment in Australia
Recruitment state(s)
SA
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Funding & Sponsors
Funding source category [1]
303591
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Hospital
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Name [1]
303591
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Lyell McEwin Hospital
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Address [1]
303591
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Haydown Road
Elizabeth Vale
SA 5112
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Country [1]
303591
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Australia
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Primary sponsor type
Hospital
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Name
Lyell McEwin Hospital
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Address
Haydown Road
Elizabeth Vale
SA 5112
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Country
Australia
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Secondary sponsor category [1]
303676
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None
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Name [1]
303676
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Address [1]
303676
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Country [1]
303676
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
304119
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Central Adelaide Local Health Network
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Ethics committee address [1]
304119
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Royal Adelaide Hospital Clinical Trial Centre Wayfinder 3D460.02 Level 3 Port Road ADELAIDE SA 5000
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Ethics committee country [1]
304119
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Australia
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Date submitted for ethics approval [1]
304119
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18/08/2019
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Approval date [1]
304119
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13/11/2019
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Ethics approval number [1]
304119
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Summary
Brief summary
The purpose of this study is to evaluate a diagnostic blood test (C-reactive protein) to detect infection and inflammation in the first 3-5 days following bowel surgery. Who is it for? You may eligible for this study if you are 18 years or older and undergoing elective colonic or rectal resection with a primary anastomosis at Lyell McEwin Hospital. Study details Patients enrolled in the study will be allocated into two groups, the control and intervention group. Participants in the control group will be monitored via standard care protocols at the hospital. The intervention group will have a blood test with a small needle in the arm on days 3, 4 and 5 after surgery. If the CRP value is above certain thresholds on these days, a 'septic screen' will be performed to look for a source of infection. The assessments that you may be involved in include, a CT scan, chest x ray, wound swab and urine/blood tests. It is hoped this research will help determine if using a clinical protocol based on the CRP to perform an infection screen will allow earlier detection of infectious complications following major colorectal surgery. It is hoped this will also allow for earlier intervention and treatment.
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Trial website
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Trial related presentations / publications
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Public notes
Ethics approval obtained for the prospective interventional group prior to recruitment into this group. This approval included retrospective review of prospectively collected data for patients in the observational group that had their operation prior to the ethical approval date.
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Contacts
Principal investigator
Name
95878
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Dr Primal Singh
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Address
95878
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Department of Surgery
Lyell McEwin Hospital
Haydown Road
Elizabeth Vale
SA 5112
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Country
95878
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Australia
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Phone
95878
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+61 8 8133 2344
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Fax
95878
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Email
95878
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[email protected]
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Contact person for public queries
Name
95879
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Primal Singh
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Address
95879
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Department of Surgery
Lyell McEwin Hospital
Haydown Road
Elizabeth Vale
SA 5112
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Country
95879
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Australia
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Phone
95879
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+61 8 8133 2344
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Fax
95879
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Email
95879
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[email protected]
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Contact person for scientific queries
Name
95880
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Primal Singh
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Address
95880
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Department of Surgery
Lyell McEwin Hospital
Haydown Road
Elizabeth Vale
SA 5112
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Country
95880
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Australia
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Phone
95880
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+61 8 8133 2344
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Fax
95880
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Email
95880
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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