MINS, AKI and Pulmonary Pathology in Patients Undergoing Acute Abdominal Surgery

Study Overview
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Brief Summary
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Explorative study to investigate potential predictors of myocardial injury, acute kidney injury and pulmonary disorder after acute high-risk abdominal surgery.

Detailed Description
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The main issues are: To investigate if coronary calcification predisposes the development of myocardial injury and causes an increased mortality rate. To evaluate the predictive value of NT-pro-BNP in relation to the development of MINS and the mortality rate. To evaluate the predictive value of different biomarkers of AKI in relation to which patients develop AKI. To examine the proteins, exosomes and single cell RNA during acute kidney injury in order to describe the molecular processes in the kidney during AKI. To examine whether a chest CT scan without contrast enhancement will change treatment decisions in the acute gastrointestinal patient compared with a chest x-ray.

Official Title
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Myocardial Injury After Non-cardiac Surgery (MINS), Acute Kidney Injury (AKI) and Pulmonary Pathology in Patients Undergoing Acute Abdominal Surgery

Conditions
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Abdomen, Acute, Myocardial Injury, Acute Kidney Injury, Pulmonary Disease

Intervention / Treatment
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* Diagnostic Test: Chest CT without contrast enhancement and chest X-ray


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults (≥18 years). Patients included in the AHA regimen undergoing CT on suspicion acute high-risk abdominal disorder e.g.g bowel obstruction GI perforation or ischemia, and need of emergency abdominal surgery, either laparoscopic surgery or laparotomy. Able to speak Danish. In case Danish was not spoken an interpreter was used to obtain the informed consent. Able to give informed consent. Exclusion Criteria: Patients who cannot give informed consent to participate in the study 15 minutes after receiving verbal information regarding the study. Known chronic kidney disease requiring dialysis at the time of admission (only exclusion criteria for the part of the study relating to AKI). Patients included in the AHA regimen, but conservative treatment is chosen (only exclusion criteria for the part of the study relating to MINS and AKI). Patients not resident in Denmark. Patients not able to give informed consent. Patient not able to speak Danish and not enough time to obtain an interpreter.

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: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: All patients<br>All patients undergo chest CT without contrast enhancement and chest X-ray. Blood and urine sampling from patients subsequently undergoing emergency laparoscopy or laparotomy. Otherwise standard care | Diagnostic Test: Chest CT without contrast enhancement and chest X-ray<br>* Chest CT without contrast enhancement and chest X-ray as supplement to diagnostic abdominal CT<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of patients with myocardial injury af non-cardiac surgery | Troponin-I above specified level and dynamic changes | 30 days | 
| Mortality rate | Postoperative mortality | 30 days | 
| Mortality rate | Postoperative mortality | 90 days | 
| Mortality rate | Postoperative mortality | 1 year | 
| Acute kidney Injury | According to KIDGO criteria | 30 days | 
| Proportion of patients with pulmonary pathology | Findings (including incidental) on a chest x-ray and chest CT scan without contrast enhancement | 1 day | 
| Proportion of patients with pulmonary complications | Postoperative complications | 30 days |