Reducing Deaths After Surgery in Low- and Middle-income Countries: A Pilot Cluster Randomised Trial

NCT ID: NCT06932653

Last Updated: 2025-04-17

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-06-01

Study Completion Date

2026-01-31

Brief Summary

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SurgPASS is a pilot randomised cluster trial utilising a pre-operative checklist with the aim of reducing deaths after surgery. If SurgPASS is successful, the intervention will be implemented in a separate full-scale cluster randomised trial.

Detailed Description

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Title: Reducing deaths after surgery in low- and middle-income countries: A pilot cluster randomised trial

Aim: This pilot randomised cluster trial aims to evaluate the feasibility of a large-scale cluster randomised trial to assess the effectiveness and implementation of a pre-operative checklist to reduce deaths after surgery. If this pilot study is successful, we aim to assess the intervention in a separate full-scale cluster randomised trial.

* Objective 1: To determine feasibility and fidelity of delivering the intervention.
* Objective 2: To determine the rate recruitment to inform how long it will take to recruit to a future cluster randomised trial.
* Objective 3: To obtain information on postoperative outcomes to help inform the outcomes used and sample size of the future cluster randomised trial.

Design: Pilot cluster randomised trial.

Inclusion: Adult (\>18 years old) non-pregnant patients undergoing emergency abdominal surgery with an incision of ≥5cm.

Exclusion: Patients undergoing minimally invasive surgery, or surgery for appendicitis.

Intervention: SurgPASS is an intervention of a preoperative checklist for early recognition and treatment of acutely unwell surgical patients implemented through simulation training and clinical champions.

Comparator: Usual care as per local practice at that site.

Follow-up period: 30-days from surgery.

Number of participants: 300 participants: 25 participants in each of 12 clusters (hospitals), from 6 countries.

Outcomes: Since this is a pilot study, there are no pre-specified primary outcomes. However, there are four key outcomes of interest to assess ahead of the main phase randomised clinical trial.

* Outcome 1: Measure simulation training and checklist completion rate for participants undergoing surgery to refine future implementation (intervention clusters only)
* Outcome 2: Measure duration of time to recruit 25 participants per cluster (to determine duration of potential full trial)
* Outcome 3: Measure 30-day overall complication rates to inform overall sample size of potential full trial

Conditions

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Post-operative Complications

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Pilot cluster randomised trial.
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Given this is a cluster trial, blinding of participants are not relevant as the entire cluster will be randomised to either the intervention or usual care.

Study Groups

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Intervention - Surgpass checklist and training champions

A preoperative checklist for early recognition and treatment of acutely unwell surgical patients implemented through simulation training and clinical champions.

Group Type EXPERIMENTAL

SurgPASS - intervention

Intervention Type OTHER

SurgPASS consists of a preoperative surgical passport used for any patients requiring emergency laparotomy, a simulation training course and local clinical champions.

Comparator - usual care

Usual care as per local practice at that site.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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SurgPASS - intervention

SurgPASS consists of a preoperative surgical passport used for any patients requiring emergency laparotomy, a simulation training course and local clinical champions.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients undergoing emergency major abdominal surgery (i.e., midline or non-midline) with an incision greater than or equal to 5cm
* Patient must not be pregnant
* Adults only (greater than or equal to 18 years old)

Exclusion Criteria

* Minimally invasive surgery
* Surgery for appendicitis
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Lagos State University

OTHER

Sponsor Role collaborator

Christian Medical College and Hospital, Ludhiana

UNKNOWN

Sponsor Role collaborator

University Teaching Hospital of Kigali

UNKNOWN

Sponsor Role collaborator

Ministry of Health, Ghana

OTHER_GOV

Sponsor Role collaborator

Université d'Abomey-Calavi

OTHER

Sponsor Role collaborator

University of Birmingham

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Aneel Bhangu

Role: PRINCIPAL_INVESTIGATOR

University of Birmingham

Locations

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University of Abomey-Calavi, Abomey-Calavi

Cotonou, , Benin

Site Status

Tamale Teaching Hospital, Tamale

Tamale, , Ghana

Site Status

Christian Medical College (CMC) & Hospital, Ludhiana, Ludhiana, 141008

Ludhiana, , India

Site Status

Lagos University Teaching Hospital (Hub), Lagos

Lagos, , Nigeria

Site Status

University Teaching Hospital of Kigali (Hub), Kigali

Kigali, , Rwanda

Site Status

Countries

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Benin Ghana India Nigeria Rwanda

Central Contacts

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Rachel Lillywhite

Role: CONTACT

+44 (0)121 415 9103

Divya Kapoor

Role: CONTACT

+44 (0)121 415 9103

Facility Contacts

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Ismail Lawani

Role: primary

Stephen Tabiri

Role: primary

Parvez Haque

Role: primary

Adesoji Ademuyiwa

Role: primary

Faustin Ntirenganya

Role: primary

Other Identifiers

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SurgPASS

Identifier Type: -

Identifier Source: org_study_id

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