Postoperative Complications in Cancer Patients Monitored With Intelligent Continuous Monitoring System

NCT ID: NCT06269198

Last Updated: 2025-01-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

504 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-10-31

Study Completion Date

2027-04-01

Brief Summary

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The primary objective of this study is to determine the effect on complication severity of using a clinical monitoring system with automatic vital sign alerts in addition to routine monitoring versus routine monitoring alone in high-risk postoperative cancer patients within 30 days after surgery.

Other objectives include documentation of the severity of complications within seven days of surgery, frequency of serious adverse events, mortality, length of stay and delay of planned chemotherapy.

Detailed Description

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The primary objective of this study is to determine the effect on complication severity of using the WARD-CSS with automatic alerts in addition to routine monitoring versus routine monitoring alone in high-risk postoperative cancer patients within 30 days after surgery.

This study is a multicenter randomized controlled trial (RCT). Patients are randomly assigned to one of two parallel monitoring groups: (1)Intervention group - Monitoring by the WARD-CSS including vital signs and active alerts relayed to the nurses' smartphones during hospitalization. (2)Control group - Blinded data collection by the WARD-CSS without vital signs and active alerts displayed to the ward staff.

Both groups will receive routine vital signs monitoring (i.e. manual spot-checks) using the regional EWS/TOKS system according to current standards of care at the participating hospitals in the Capital Region or the Central Denmark Region.

The study is a collaboration between Rigshospitalet, Bispebjerg and Frederiksberg Hospital, and Hvidovre Hospital.

Patients will be recruited from abdominal (gastrointestinal, gynecological, or urological) surgery wards at the study sites.

Patients will be randomized post-surgery at the postoperative units/ post-anesthesia-care unit or after arrival at the ward. Continuous wireless monitoring (i.e., unblinded with alerts or blinded) will commence immediately after randomization in the study.

Only randomized patients will be included in the study population. Drop-outs prior to randomization will not be part of the study population.

The first 14 days of active enrollment at each new study site that has not previously used WARD-CSS will be used to align study procedures, verify system connectivity, etc. During this period, up to ten patients at each study site will be enrolled to be monitored similar to the intervention group. These run-in patients will not be randomized and will not be considered part of the study population.

Conditions

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Postoperative Complications Cancer, Treatment-Related

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomisation stratified by study site
Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Outcome Assessors
Participants will not be given information on group allocation. Care-providers will not be blinded, due to having to carry out the intervention.

Investigator will not be blinded to carrie out roles such as safety surveillance, error-solving and quality assurance.

Outcome assessor will be blinded to study allocation.

Study Groups

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Control arm

Blinded data collection by the WARD-CSS without vital signs and active alerts displayed to the ward staff

Group Type NO_INTERVENTION

No interventions assigned to this group

Intervention arm

Monitoring by the WARD-CSS including vital signs and active alerts relayed to the nurses' smartphones during hospitalization

Group Type EXPERIMENTAL

WARD-CSS

Intervention Type DEVICE

Patients' continuously monitored vital signs will be recorded via a bedside tablet device (data not visible).

The clinical staff will have access to the continuously monitored vital signs through a mobile device (smart phone) with a purpose-built app-based GUI displaying vital sign status and summaries, alarms, and device connectivity. The GUI will alert the clinical staff (acoustic and visual signals) when any of the predefined thresholds for deviating vital signs are exceeded.

Interventions

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WARD-CSS

Patients' continuously monitored vital signs will be recorded via a bedside tablet device (data not visible).

The clinical staff will have access to the continuously monitored vital signs through a mobile device (smart phone) with a purpose-built app-based GUI displaying vital sign status and summaries, alarms, and device connectivity. The GUI will alert the clinical staff (acoustic and visual signals) when any of the predefined thresholds for deviating vital signs are exceeded.

Intervention Type DEVICE

Other Intervention Names

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Continuous vital signs monitoring with real-time alerts

Eligibility Criteria

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Inclusion Criteria

* Admission for elective major abdominal (gastrointestinal, gynecological, or urological) surgery with the primary aim of radical surgery/removing suspected cancer tissue.
* At least two expected postoperative admission days
* Laparotomy or laparoscopy procedure estimated to last more than 2 hours.
* Co-enrolment of patients in other studies is acceptable but in studies involving interventions which potentially will affect the continuous monitoring of vital signs and/or the primary or secondary outcomes, an assessment of whether these patients can be co-enrolled in the WARD-RCT should be conferred with the WARD RCT steering committee.

Exclusion Criteria

* Patient expected not to cooperate with study procedures
* Allergy to study materials (silicone, plaster)
* Impaired cognitive function (in uncertain cases assessed by a Mini Mental State Examination score \< 24). (Protocol Appendix E)
* Patients with a pacemaker or Implantable Cardioverter Defibrillator (ICD) device
* Inability to give informed consent
* Patients with planned hyperthermic intraperitoneal chemotherapy (HIPEC) procedure or two-stage resections (two-stage hepatectomy, two-stage resection of malignant colorectal obstructions, etc.)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bispebjerg Hospital

OTHER

Sponsor Role collaborator

Hvidovre University Hospital

OTHER

Sponsor Role collaborator

Rigshospitalet, Denmark

OTHER

Sponsor Role lead

Responsible Party

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Jesper Mølgaard

MD, PhD, Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jesper Mølgaard, PhD

Role: PRINCIPAL_INVESTIGATOR

Rigshospitalet, Denmark

Locations

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Copenhagen University hospital - Rigshospitalet

Copenhagen, Other (Non US), Denmark

Site Status RECRUITING

Bispebjerg Hospital

Copenhagen, Other (Non US), Denmark

Site Status RECRUITING

Hvidovre Hospital

Hvidovre, Other (Non US), Denmark

Site Status NOT_YET_RECRUITING

Countries

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Denmark

Central Contacts

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Jesper Mølgaard, PhD

Role: CONTACT

+4535453545

Facility Contacts

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Jesper Mølgaard, PhD

Role: primary

+4535453545

Eske K Aasvang, DMSc

Role: backup

+4535450802

Christian S Meyhoff, PhD

Role: primary

+4524910542

Katja B L Glud, RN

Role: primary

+4538625713

Other Identifiers

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WARD - SX - RCT II

Identifier Type: -

Identifier Source: org_study_id

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