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DAMASCUS study to investigate variability in the presentation and index management of acute diverticulitis

Mon, 02/10/2020 - 11:12
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The DAMASCUS study is an international, prospective study aiming to investigate the international variability in the presentation and index management of acute diverticulitis, and whether there is an association between index management and short and medium-term clinical outcomes including the readmission or re-intervention rates over the subsequent six months. The trainee-led study with local consultant support started in January 2020 and will run for six months, with last follow-up data to be collected in December 2020.

Funded by the Bowel Disease Research Foundation in the UK and coordinated via the Birmingham Surgical Trials Consortium, the study protocol states there are very little prospective data regarding this perceived international variation, and furthermore there are specific subgroups of patients with acute diverticulitis such as diverticular abscess in which very little is known about the optimal management.

Therefore, this study will audit the different types of management employed in patients presenting with acute diverticulitis. The aim is to explore whether an international variation in practice exists and if there is association between index management and short- and medium-term clinical outcomes only. From this dataset, the variations in the index management and corresponding outcomes of patients with acute diverticulitis will be assessed.

This study will not investigate any patient reported outcomes, but it is hoped that the findings of this study will inform the design of future studies of acute diverticulitis which will collect patient level data.

Primary objective

  • To prospectively audit the national and international variability in the presentation and index management of acute diverticulitis

Secondary objectives

  • What are the national and international variations in operating strategies employed for those patients undergoing surgery?
  • What are the international variations in 30-day (post index admission) mortality rates?

Outcomes

  • The short-term clinical outcomes at 30-days (from index admission)
  • Readmission and/or re-intervention rates at 6-months (from index admission)
  • Clinical outcomes post radiological and/or surgical intervention
  • If any patient- or disease-specific covariates affect treatment strategy or short term clinical outcomes
  • Clinician equipoise for the recruitment of patients to future randomised controlled trials

At least 80 acute general or university teaching hospitals, the study will be conducted across the Tripartite regions; UK, America, Australasia and Europe. Patients recruited to the study will be adults attending hospital acutely with acute diverticulitis (CT proven or diagnosed during surgery for acute peritonitis) who undergo conservative, radiological or surgical treatment for their disease.

The last patients are expected to be recruited in May 2020 and the last follow up data collected in December 2020,

To find out more about the DAMASCUS study, please click here