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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05470816
Registration number
NCT05470816
Ethics application status
Date submitted
5/07/2022
Date registered
22/07/2022
Titles & IDs
Public title
Tranexamic Acid to Reduce Delirium After Gastrointestinal Surgery: the TRIGS-D Trial
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Scientific title
Tranexamic Acid to Reduce Delirium After Gastrointestinal Surgery: the TRIGS-D Trial (a Substudy of the TRIGS Trial)
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Secondary ID [1]
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58/20
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Universal Trial Number (UTN)
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Trial acronym
TRIGS-D
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Surgical Site Infection
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Dementia
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Cognition
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Condition category
Condition code
Infection
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Other infectious diseases
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Surgery
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Other surgery
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Neurological
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Other neurological disorders
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Mental Health
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Other mental health disorders
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Mental Health
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Psychosis and personality disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Tranexamic Acid 100Mg/ml Inj Vial 10ml
Treatment: Drugs - Placebo
Active comparator: Tranexamic Acid - 12 mg/kg, before surgical incision, and then an infusion of 3 mg/kg/h until the end of surgery.
Placebo comparator: Placebo - 12 mg/kg, before surgical incision, and then an infusion of 3 mg/kg/h until the end of surgery.
Treatment: Drugs: Tranexamic Acid 100Mg/ml Inj Vial 10ml
Intervention is from the Tranexamic acid to Reduce Infection after Gastrointestinal Surgery: the TRIGS Trial. A multicentre, pragmatic, double-blind, randomised clinical trial will compare the incidence of surgical site infection and red cell transfusion requirements after IV tranexamic acid and placebo in patients undergoing gastrointestinal surgery
Treatment: Drugs: Placebo
Normal saline
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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incidence of delirium in the first 3 days postoperatively
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Assessment method [1]
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3D-Confusion Assessment Method (3D-CAM) or CAM-ICU if the Used to measure delirium. Assessments will be conducted twice daily A classification of delirium will be made if both features 1 and 2 are present
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Timepoint [1]
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post surgical incision to day 3 (at anytime)obtaining information from the patient, family and staff, and thorough chart review
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Secondary outcome [1]
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Delirium severity
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Assessment method [1]
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3D-CAM-S
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Timepoint [1]
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post surgical incision to day 3 (inclusive)
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Secondary outcome [2]
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Quality of Life Intergroup differences
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Assessment method [2]
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using the Short form survey 12 - Quality of Life Intergroup differences in long-term (12 month) in perioperative cognitive decline
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Timepoint [2]
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12 months post surgical incision
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Secondary outcome [3]
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Disability
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Assessment method [3]
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World Health Organization disability assessment schedule. Intergroup differences in long-term (12 month) in perioperative cognitive decline
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Timepoint [3]
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12 months post surgical incision
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Secondary outcome [4]
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perioperative neurocognitive disorders (NCDs)
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Assessment method [4]
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NCD will be defined as any of: (i) subjective complaint, (ii) a 4-point reduction in TICS-B, (iii) SF or VF, and (iv) functional deficit defined as a reduction in WHODAS score of 5% or more from baseline (before surgery).
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Timepoint [4]
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12 months post surgical incision
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Secondary outcome [5]
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Days at home up to 30 days after surgery (DAH30)
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Assessment method [5]
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DAH30 is patient-centred and reflects the patient's primary aim of a healthy recovery, reduced hospital costs and serious complications, and avoiding re-admission (often due to postoperative delirium).
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Timepoint [5]
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30 days post surgical incision post surgical incision
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Secondary outcome [6]
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cytokine levels
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Assessment method [6]
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Blood tests measured in 92 key inflammatory/immune markers using technology
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Timepoint [6]
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preoperative, postoperative day 1 and 3 post surgical incision
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Secondary outcome [7]
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neuronal injury biomarker
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Assessment method [7]
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used to evaluate temporal changes in the innate cellular immune and inflammatory profile, and for changes in fibrinolysis
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Timepoint [7]
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preoperative, postoperative day 1 and 3 post surgical incision
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Eligibility
Key inclusion criteria
Inclusion criteria
* Adult patients scheduled for elective gastrointestinal (oesophageal, gastric, hepatobiliary, colorectal) surgery
* with 2 or more risk factors for complications:
* age =70 years,
* American Society of Anesthesiologists (ASA) physical status 3 or 4,
* heart failure, diabetes,
* chronic respiratory disease,
* obesity (BMI =30 kg/m2),
* vascular disease,
* preoperative haemoglobin <100 g/L,
* renal impairment (se. creatinine =150 micromol/L), or low albumin (<30 g/L).
* Written informed consent will be obtained.
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Minimum age
18
Years
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Maximum age
100
Years
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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
Exclusion criteria
* Poor spoken and/or written language comprehension,
* laparoscopic and other minor (eg. closure of stoma) surgery,
* pre-existing infection/sepsis,
* history of spontaneous pulmonary embolism or arterial thrombosis,
* current arterial or venous thrombosis,
* familial thrombophilia (e.g. Lupus anticoagulant, protein C deficiency, factor V Leiden),
* contraindication to TxA.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled 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
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/11/2022
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
31/12/2025
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Actual
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Sample size
Target
826
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Alfred Health - Melbourne
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Recruitment postcode(s) [1]
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3181 - Melbourne
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Funding & Sponsors
Primary sponsor type
Government body
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Name
Bayside Health
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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Monash University
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
Prophylactic TxA administration in patients undergoing major gastrointestinal surgery reduces the incidence of delirium after surgery when compared with placebo. The unifying hypothesis is that systemic and neuro-inflammation lead to neuronal injury and resultant postoperative delirium.
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Trial website
https://clinicaltrials.gov/study/NCT05470816
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Paul S Myles, DSci
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Address
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Monash University
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Paul S Myles, DSci
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Address
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Country
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Phone
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+61390763176
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Following written request and review by the steering committee
Supporting document/s available: Study protocol, Statistical analysis plan (SAP)
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When will data be available (start and end dates)?
Following analysis for the publication
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Available to whom?
Written request
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT05470816