Acute High-risk Abdominal Surgery Study - an Optimized Perioperative Course

Study Overview
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Brief Summary
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The objective of this study is to implement an optimized perioperative course for patients undergoing acute high-risk abdominal surgery in order to improve the outcome. The optimized perioperative course consists of a number of interventions carried out before, during and after surgery.

Detailed Description
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Emergency surgery is associated with high mortality rates, post-operative complications and prolonged duration of hospital admission. The investigators will implement a multidisciplinary optimized perioperative course consisting of a number of interventions carried out before, during and after surgery. Hypothesis: An optimized perioperative course will reduce the 30-day mortality in emergency abdominal surgery patients. The investigators will do a post-hoc analysis of the data registered.

Official Title
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Acute High-risk Abdominal Surgery Study - an Optimized Perioperative Course

Conditions
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Perforated Viscus, Intestinal Obstruction

Intervention / Treatment
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* Procedure: AHA (Acute Highrisk Abdominalsurgery): Optimized Course


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients undergoing primary emergency laparotomy or laparoscopy patients undergoing reoperation after abdominal surgery. Age > 18 years Exclusion Criteria: Appendectomy Emergency laparoscopic cholecystectomy Emergency diagnostic laparoscopy without intervention

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: historic control group<br>Standard treatment in the historic control group | |
| Active Comparator: Intervention group<br>AHA (Acute Highrisk Abdominalsurgery): Optimized Course: Intervention before, during and after abdominal surgery. Focus on fast track with multimodal standardized intervention: standardized preparing for surgery including high dose antibiotics and epidural analgesia etc. and transfer to intermediate care before surgery (the post-anaesthesia care unit) GDT-LiDCO fluid management pre-, per- and postoperative Postoperative triage to 24 hour intermediate care based on ASA score and Surgical Apgar Score Focus on early mobilization, fysiotherapy and optimal nutrition postoperatively | Procedure: AHA (Acute Highrisk Abdominalsurgery): Optimized Course<br>* optimized course: Intervention before, during and after abdominal surgery. Focus on fast track with multimodal standardized intervention: standardized preparing for surgery including high dose antibiotics and epidural analgesia etc. and transfer to intermediate care before surgery (the post-anaesthesia care unit) GDT-LiDCO fluid management pre-, per- and postoperative Postoperative triage to 24 hour intermediate care based on ASA score and Surgical Apgar Score Focus on early mobilization, fysiotherapy and optimal nutrition postoperatively<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mortality rate |  | Within 30 days of surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Emergency laparotomy, Emergency laparoscopy