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Status unknownNCT03788005GET-UPUpdated Aug 24, 2021

GET-UP Trial: Impact of an Early Out-of-bed Paradigm in Postoperative Outcomes of Chronic Subdural Hematomas

An interventional study of Early mobilization in Chronic Subdural Hematoma, sponsored by Centro Hospitalar do Porto. Status unknown at 1 site in Portugal. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-08-24.

Sponsored by Centro Hospitalar do Porto · Not applicable, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Aug 2021), so the status shown — last known as Active, not recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
208
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Compare rates of medical complications, recurrence and outcome in 2 randomized groups of patients with surgical chronic subdural hematomas. The intervention group will be assigned to early mobilization (within 12 hours of the surgical procedure). The control group will be assigned to bed rest for 48 hours.

Read the detailed description

At Centro Hospitalar do Porto it is routinely used burr hole craniostomy with subdural drains and 48 hours of bed rest for the surgical treatment of chronic subdural hematomas. After 48 hours the subdural drains are removed and the patient is allowed to mobilize for the first time.

The aim of the present study is to conduct a prospective, randomized, controlled trial with an early mobilization protocol vs 48 hours bed rest to determine the best strategy to reduce postoperative complications and improve functional outcomes.

There will be 2 groups:

  • Control group: bed rest 48 hours post-surgery with removal of subdural drains after this period.
  • Intervention group: Early mobilization protocol: as early mobilization as possible, within a maximum of 12 hours following surgery, with progressive autonomization in the ward as tolerated by the patient. Mobilization time will be recorded. At the time of assuming an upright position the drains will be closed and will only be open again when the patient is in supine position (8 hours per day of supine position). Subdural drains will be removed after 48 hours, similar to the practice in the control group.

Primary End-Point:

  • Number of medical complications. Medical complication is defined as any occurrence which merits additional tests or, preferentially, requires any form of medical treatment. This includes respiratory infections, urinary infections, wound infections, meningitis, deep vein thrombosis, pulmonary embolism, cerebral infarction or hemorrhage, syncope, among others.

Secondary End-Points:

  • Recurrence rates. A recurrence is defined as any chronic subdural hematoma ipsilateral to that of the original hematoma if a surgical strategy needs to be pursued.
  • Functional status (using both GOS-E and mRS). Timeframes considered will be pre-operative functional status, functional status at discharge, functional status at 3 months post-operative.
  • Mortality rates.
  • Recurrence free survival.
  • Time to discharge.
02

Conditions studied

  • Chronic Subdural Hematoma

Keywords

  • Chronic Subdural Hematoma
  • Bed rest
  • Early mobilization
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Surgically drained chronic subdural hematomas (Burr hole craniostomy)
  • > or equal to 18 years old

Exclusion criteria

Exclusion Criteria:

  • Previous neurosurgery
  • Surgery for another pathology performed at the same time
  • > 6h sedation post-surgery
  • Any previous condition that makes early mobilization impossible
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
208 participants (actual)

Study arms

  • Active comparator
    Intervention group

    Early mobilization as soon as possible, within a maximum of 12 hours post-surgery. Subdural drains will be closed when the patient is allowed to mobilize and will be open during a nocturnal period of 8 hours. Subdural drains will be removed past 48 hours of surgery.

    Procedure: Early mobilization

  • No intervention
    Control Group

    Bed rest with head of bed at 0 degrees for 48h. Subdural drains will be removed past 48 hours of surgery.

Interventions

  • ProcedureEarly mobilization

    Early mobilization as soon as possible and within a maximum of 12 hours following burr hole craniostomy for chronic subdural hematomas.

05

What researchers measure

Primary outcomes

  1. Medical Complications

    Infections, venous thromboembolism, seizures

    Time frame: From date of randomization until 3 months post-randomization

Secondary outcomes

  1. Recurrence

    Recurrence of a chronic subdural hematoma if surgical intervention is required

    Time frame: At 3 months follow-up

  2. Post-operative Modified Rankin scale

    Modified Rankin Scale from 0 (free of symptoms) to a maximum of 6 (dead)

    Time frame: At 3 months follow-up

  3. Survival

    Survival

    Time frame: At 3 months follow-up

  4. Length of hospital stay

    Time to clinical discharge

    Time frame: From date of randomization until clinical discharge up to 36 months

  5. Post-operative GOS-E scale

    GOS-E scale from 1 (dead) to a maximum of 8 (upper good recovery - resumption of normal life within the capacity work even if pre-injury status has not been achieved; any existing deficits are not disabling)

    Time frame: At 3 months follow-up

06

Study locations

1 site
  • Centro Hospitalar Universitário do Porto
    Porto, 4000, Portugal
07

References and documents

Publications

  • Kurabe S, Ozawa T, Watanabe T, Aiba T. Efficacy and safety of postoperative early mobilization for chronic subdural hematoma in elderly patients. Acta Neurochir (Wien). 2010 Jul;152(7):1171-4. doi: 10.1007/s00701-010-0627-4. Epub 2010 Mar 25. PubMed 20336332 ↗
  • Brennan PM, Kolias AG, Joannides AJ, Shapey J, Marcus HJ, Gregson BA, Grover PJ, Hutchinson PJ, Coulter IC; British Neurosurgical Trainee Research Collaborative. The management and outcome for patients with chronic subdural hematoma: a prospective, multicenter, observational cohort study in the United Kingdom. J Neurosurg. 2017 Oct;127(4):732-739. doi: 10.3171/2016.8.JNS16134. Epub 2016 Nov 11. PubMed 27834599 ↗

Individual participant data

Plan to share: Undecided

08

Registry details

Key details

Study ID
NCT03788005
Lead sponsor
Centro Hospitalar do Porto
Responsible party
Sérgio Sousa (Principal Investigator, Centro Hospitalar do Porto) — Principal investigator
First posted
Dec 27, 2018
Start date
Apr 7, 2019
Primary completion
Aug 5, 2021
Completion
Aug 5, 2022 (estimated)
Last update
Aug 24, 2021

Study contacts

Sérgio Sousa, MD
principal investigator · Centro Hospitalar do Porto

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is status unknown, as verified in Aug 2021. You cannot join it, but the record below documents what was studied.

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