CHESTY trial: Chest infection prevalence after surgery

An international multi-centre observational trial investigating the incidence of respiratory complications in adults following major surgery.

Principal investigator: Dr Ianthe Boden (Launceston General Hospital and the University of Melbourne).

Two healthcare professionals in navy scrubs discuss patient documentation at a hospital workstation, with a busy clinical environment in the background.

Recruitment is now complete.

CHESTY aimed to determine the incidence of postoperative pulmonary complications (PPC) using standardised diagnostic criteria in the first seven postoperative days following major non-orthopaedic surgery.

Secondary aims

  1. Determine the incidence of pneumonia, systemic inflammatory response syndrome (SIRS), sepsis, ICU length of stay (LOS), unplanned ICU readmission rates, reintubation rates, hospital LOS, and in-hospital mortality. 
  2. Audit perioperative physiotherapy service delivery.
  3. Investigate associative relationships between causative factors and preventative therapies for PPC.
  4. Ascertain concordance between generic assessment of PPC, pneumonia, SIRS, and sepsis. 
  5. To develop risk predication models in different surgical groups for those at risk of developing PPC.

Hypothesis
Determination of PPC incidence and other outcomes within a large multi-centre observational trial utilising standardised diagnostic criteria will allow benchmarking in comparison to other centres. Results will inform targeted delivery of physiotherapy and other medical services to reduce preventable PPC in risk populations. Data will inform randomised control trial sample size calculations to test interventions to reduce PPC.

5200 patients were enrolled between May 2017 and July 2020 at 35 centres in Australia, New Zealand, Sweden, Canada and Malaysia.

Clifford Craig Foundation.

Australian New Zealand Clinical Trials Registry: ACTRN12616001020471

For further information about this study, please contact the CHESTY principal investigator, Dr Ianthe Boden by email.