How Institutional Guidelines for Urgent Inpatient Surgeries Affect Intensity of Perioperative Cardiovascular Testing
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- This is an observational study: the protocol does not assign a study treatment.
- Who it may be relevant to
- Registry conditions: Major Adverse Cardiovascular Events, Cardiovascular Testing and Consultation Intensity. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
PERLHS: How Institutional Guidelines for Urgent Inpatient Surgeries Affect Intensity of Perioperative Cardiovascular Testing: A PrePost Study
Overview
This study will evaluate the impact of implementing an educational clinical decision support (CDS) tool designed to guide perioperative cardiovascular evaluation for adults undergoing urgent inpatient surgery. The CDS tool, integrated within the Epic electronic health record via AgileMD, provides evidence-informed recommendations regarding perioperative cardiac testing and specialty consultation based on American Heart Association guidance and multidisciplinary institutional consensus. The investigators will conduct a retrospective and prospective pre-post observational cohort study comparing perioperative cardiovascular testing intensity, consultation patterns, time to operating room, and clinical outcomes before and after implementation of the tool among adult patients admitted through the emergency department at Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center who undergo urgent surgery. Data will be obtained from the Core for Clinical Research Data Acquisition (CCDA) and Epic electronic health record, with case-level chart review performed as needed to validate rare outcomes such as major adverse cardiac events.
Primary outcome measures
- Rate of preoperative tests and consult orders [Time frame: From Presentation to the ED to 6 months post presentation]
Secondary outcome measures (2)
- Major Adverse Cardiac Events (MACE) [Time frame: From presentation at the ED to 6 months post presentation]
- Time to OR [Time frame: 0 hours to 5 days]
Eligibility criteria
Inclusion criteria
- Adults age 18 years or older
- Admitted through the Emergency Department at Johns Hopkins Hospital or Johns Hopkins Bayview Medical Center Undergoing urgent inpatient surgery during the index hospitalization
Exclusion criteria
- Elective surgeries,
- Outpatient procedures,
- Procedures followed only by observation or extended-stay recovery rather than inpatient admission,
- Patients younger than 18 years old
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Cohort
Study locations
Center list to be confirmed — check the primary protocol.
Identifiers
NCT: NCT07692503 · IRB00554070 · AHRQ-PCORI LHS P30 H5029772