The University of Southampton
University of Southampton Institutional Repository

Systematic review and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: infection and sepsis

Systematic review and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: infection and sepsis
Systematic review and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: infection and sepsis

Background: Perioperative infection and sepsis are of fundamental concern to perioperative clinicians. However, standardised endpoints are either poorly defined or not routinely implemented. The Standardised Endpoints in Perioperative Medicine (StEP) initiative was established to derive a set of standardised endpoints for use in perioperative clinical trials. Methods: We undertook a systematic review to identify measures of infection and sepsis used in the perioperative literature. A multi-round Delphi consensus process that included more than 60 clinician researchers was then used to refine a recommended list of outcome measures. Results: A literature search yielded 1857 titles of which 255 met inclusion criteria for endpoint extraction. A long list of endpoints, with definitions and timescales, was generated and those potentially relevant to infection and sepsis circulated to the theme subgroup and then the wider StEP-COMPAC working group, undergoing a three-stage Delphi process. The response rates for Delphi rounds 1, 3, and 3 were 89% (n=8), 67% (n=62), and 80% (n=8), respectively. A set of 13 endpoints including fever, surgical site, and organ-specific infections as defined by the US Centres for Disease Control and Sepsis-3 are proposed for future use. Conclusions: We defined a consensus list of standardised endpoints related to infection and sepsis for perioperative trials using an established and rigorous approach. Each endpoint was evaluated with respect to validity, reliability, feasibility, and patient centredness. One or more of these should be considered for inclusion in future perioperative clinical trials assessing infection, sepsis, or both, thereby permitting synthesis and comparison of future results.

core outcome measures, infection, perioperative medicine, postoperative outcome, sepsis, standardised endpoints, surgical site infection
0007-0912
500-508
Barnes, Jonathan
8ceefd75-1306-4c4c-b491-626208712e9d
Hunter, Jennifer
0d62b5d8-af09-49c5-bf87-983e670a9780
Harris, Steve
a397eda9-8d7d-4540-8e03-1121eb58df3c
Shankar-Hari, Manu
6168fb5a-39fd-4713-a885-e7479d6b6775
Diouf, Elisabeth
00dac94c-630d-43af-b940-125eb3765e6e
Jammer, Ib
fc68000f-c0ce-493e-a7c7-649716b25838
Kalkman, Cor
745a84aa-eaa6-4ab4-b071-3c16a4f34dea
Klein, Andrew A.
661f0e3b-3435-4b05-aca9-a9bd17ed4faf
Corcoran, Tomas
7e55930f-889c-4052-9638-7a1baaaaa25d
Dieleman, Stefan
316f8174-06c0-4c89-9185-4e78c5610dd8
Grocott, Michael P.W.
1e87b741-513e-4a22-be13-0f7bb344e8c2
Mythen, Michael G.
940f5be7-e5bc-4a90-94aa-09fdc658caad
Myles, Paul
33760c6d-ba95-4948-8d8f-43be43aad3f5
Gan, Tang Joon
928adf17-89be-48c5-aca7-c374dfa35f03
Kurz, Andrea
48b45843-6dc9-4884-b406-ee595cf5d506
Peyton, Phil
193c3beb-ec68-4d9e-a28d-1fbe6eead047
Sessler, Dan
d6332e46-8f2c-49f9-9937-6ae9f473b049
Tramèr, Martin
1e42d6d2-4be2-4339-973a-aaccc11d7895
Cyna, Alan
c31d9baf-b930-43d8-a9df-41439fa41cc2
De Oliveira, Gildasio S.
5a4e084e-800a-4c4d-aa55-977be5550765
Wu, Christopher
8f1425f1-6789-4a98-a072-cd4772e0fe1d
Jensen, Mark
ee79e2fe-da4f-455e-be9d-df80a6515907
Kehlet, Henrik
331009ae-8710-4ec1-8f6f-165090051a37
Botti, Mari
82acd6e1-fa4b-4f82-977b-395648caba51
Boney, Oliver
e1b79df2-34eb-4d75-af8b-e18327c7b8e1
Haller, Guy
aa094ca6-53ec-460d-b248-b471ae8102c6
Grocott, Michael P.W.
1e87b741-513e-4a22-be13-0f7bb344e8c2
Cook, Tim
452af468-4765-4c01-97c2-a0f90796a0b2
Fleisher, Lee
877c95e8-46f3-4629-8a9a-9ced19d91ba5
Neuman, Mark
75c401b4-8513-4171-9ebc-060440593696
Story, David
bfca9f56-911d-4806-bcd8-19e05a1bb506
Gruen, Russell
9791e532-1a16-4303-a006-6a6179060af4
Bampoe, Sam
edf2e763-1a6a-474b-9534-6d2c982735ed
Evered, Lis
9772c0d6-3acb-4945-8c08-a94d96171b7b
Scott, David
0892cf14-6777-4be7-803b-0bff2854ebfc
Silbert, Brendan
7867f210-717b-4b0b-bae9-c4e178facf3f
van Dijk, Diederik
94251e79-17a6-48bc-a386-082a7e599211
Chan, Matthew
22fdc8e6-5106-492c-a71e-f77d28f79e23
Grocott, Hilary
79bb47a2-6d54-4a66-a9f0-53b58fd808c4
Eckenhoff, Rod
776f5135-f9de-41c5-894d-65d514b0bbd4
Rasmussen, Lars
926f31e6-541c-45f4-9870-2ceabff4dd6c
Eriksson, Lars
340ffb17-9c8e-468f-acba-13219dc22c37
Beattie, Scott
c79d8200-7231-4645-af91-f430d815ff08
Wijeysundera, Duminda
4163d34d-519b-46cb-8305-3a68f8c53d53
Landoni, Giovanni
507e42ec-1bb5-45cd-9426-872609912ed5
Leslie, Kate
addf3a82-f587-4650-ba5a-7d0eb4cfc84a
Biccard, Bruce
7d9e9919-ceed-49cc-8e01-165c384e3f4d
Cooper, David James
0b4ecdad-664b-4e94-b51e-920c13080cfc
Shaw, Andrew
4afa8737-18d4-4c88-98a4-55572fb51562
Johnson, Mark
64135487-45a1-46a6-a34b-595143e3c9a6
the StEP-COMPAC Group
Barnes, Jonathan
8ceefd75-1306-4c4c-b491-626208712e9d
Hunter, Jennifer
0d62b5d8-af09-49c5-bf87-983e670a9780
Harris, Steve
a397eda9-8d7d-4540-8e03-1121eb58df3c
Shankar-Hari, Manu
6168fb5a-39fd-4713-a885-e7479d6b6775
Diouf, Elisabeth
00dac94c-630d-43af-b940-125eb3765e6e
Jammer, Ib
fc68000f-c0ce-493e-a7c7-649716b25838
Kalkman, Cor
745a84aa-eaa6-4ab4-b071-3c16a4f34dea
Klein, Andrew A.
661f0e3b-3435-4b05-aca9-a9bd17ed4faf
Corcoran, Tomas
7e55930f-889c-4052-9638-7a1baaaaa25d
Dieleman, Stefan
316f8174-06c0-4c89-9185-4e78c5610dd8
Grocott, Michael P.W.
1e87b741-513e-4a22-be13-0f7bb344e8c2
Mythen, Michael G.
940f5be7-e5bc-4a90-94aa-09fdc658caad
Myles, Paul
33760c6d-ba95-4948-8d8f-43be43aad3f5
Gan, Tang Joon
928adf17-89be-48c5-aca7-c374dfa35f03
Kurz, Andrea
48b45843-6dc9-4884-b406-ee595cf5d506
Peyton, Phil
193c3beb-ec68-4d9e-a28d-1fbe6eead047
Sessler, Dan
d6332e46-8f2c-49f9-9937-6ae9f473b049
Tramèr, Martin
1e42d6d2-4be2-4339-973a-aaccc11d7895
Cyna, Alan
c31d9baf-b930-43d8-a9df-41439fa41cc2
De Oliveira, Gildasio S.
5a4e084e-800a-4c4d-aa55-977be5550765
Wu, Christopher
8f1425f1-6789-4a98-a072-cd4772e0fe1d
Jensen, Mark
ee79e2fe-da4f-455e-be9d-df80a6515907
Kehlet, Henrik
331009ae-8710-4ec1-8f6f-165090051a37
Botti, Mari
82acd6e1-fa4b-4f82-977b-395648caba51
Boney, Oliver
e1b79df2-34eb-4d75-af8b-e18327c7b8e1
Haller, Guy
aa094ca6-53ec-460d-b248-b471ae8102c6
Grocott, Michael P.W.
1e87b741-513e-4a22-be13-0f7bb344e8c2
Cook, Tim
452af468-4765-4c01-97c2-a0f90796a0b2
Fleisher, Lee
877c95e8-46f3-4629-8a9a-9ced19d91ba5
Neuman, Mark
75c401b4-8513-4171-9ebc-060440593696
Story, David
bfca9f56-911d-4806-bcd8-19e05a1bb506
Gruen, Russell
9791e532-1a16-4303-a006-6a6179060af4
Bampoe, Sam
edf2e763-1a6a-474b-9534-6d2c982735ed
Evered, Lis
9772c0d6-3acb-4945-8c08-a94d96171b7b
Scott, David
0892cf14-6777-4be7-803b-0bff2854ebfc
Silbert, Brendan
7867f210-717b-4b0b-bae9-c4e178facf3f
van Dijk, Diederik
94251e79-17a6-48bc-a386-082a7e599211
Chan, Matthew
22fdc8e6-5106-492c-a71e-f77d28f79e23
Grocott, Hilary
79bb47a2-6d54-4a66-a9f0-53b58fd808c4
Eckenhoff, Rod
776f5135-f9de-41c5-894d-65d514b0bbd4
Rasmussen, Lars
926f31e6-541c-45f4-9870-2ceabff4dd6c
Eriksson, Lars
340ffb17-9c8e-468f-acba-13219dc22c37
Beattie, Scott
c79d8200-7231-4645-af91-f430d815ff08
Wijeysundera, Duminda
4163d34d-519b-46cb-8305-3a68f8c53d53
Landoni, Giovanni
507e42ec-1bb5-45cd-9426-872609912ed5
Leslie, Kate
addf3a82-f587-4650-ba5a-7d0eb4cfc84a
Biccard, Bruce
7d9e9919-ceed-49cc-8e01-165c384e3f4d
Cooper, David James
0b4ecdad-664b-4e94-b51e-920c13080cfc
Shaw, Andrew
4afa8737-18d4-4c88-98a4-55572fb51562
Johnson, Mark
64135487-45a1-46a6-a34b-595143e3c9a6

the StEP-COMPAC Group (2019) Systematic review and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: infection and sepsis. British Journal of Anaesthesia, 122 (4), 500-508. (doi:10.1016/j.bja.2019.01.009).

Record type: Review

Abstract

Background: Perioperative infection and sepsis are of fundamental concern to perioperative clinicians. However, standardised endpoints are either poorly defined or not routinely implemented. The Standardised Endpoints in Perioperative Medicine (StEP) initiative was established to derive a set of standardised endpoints for use in perioperative clinical trials. Methods: We undertook a systematic review to identify measures of infection and sepsis used in the perioperative literature. A multi-round Delphi consensus process that included more than 60 clinician researchers was then used to refine a recommended list of outcome measures. Results: A literature search yielded 1857 titles of which 255 met inclusion criteria for endpoint extraction. A long list of endpoints, with definitions and timescales, was generated and those potentially relevant to infection and sepsis circulated to the theme subgroup and then the wider StEP-COMPAC working group, undergoing a three-stage Delphi process. The response rates for Delphi rounds 1, 3, and 3 were 89% (n=8), 67% (n=62), and 80% (n=8), respectively. A set of 13 endpoints including fever, surgical site, and organ-specific infections as defined by the US Centres for Disease Control and Sepsis-3 are proposed for future use. Conclusions: We defined a consensus list of standardised endpoints related to infection and sepsis for perioperative trials using an established and rigorous approach. Each endpoint was evaluated with respect to validity, reliability, feasibility, and patient centredness. One or more of these should be considered for inclusion in future perioperative clinical trials assessing infection, sepsis, or both, thereby permitting synthesis and comparison of future results.

This record has no associated files available for download.

More information

Accepted/In Press date: 8 January 2019
e-pub ahead of print date: 14 February 2019
Published date: 1 April 2019
Keywords: core outcome measures, infection, perioperative medicine, postoperative outcome, sepsis, standardised endpoints, surgical site infection

Identifiers

Local EPrints ID: 429290
URI: http://eprints.soton.ac.uk/id/eprint/429290
ISSN: 0007-0912
PURE UUID: 0eb7934a-6b60-4163-8942-3cc3ed43b767
ORCID for Michael P.W. Grocott: ORCID iD orcid.org/0000-0002-9484-7581
ORCID for Michael P.W. Grocott: ORCID iD orcid.org/0000-0002-9484-7581

Catalogue record

Date deposited: 26 Mar 2019 17:30
Last modified: 18 Mar 2024 03:12

Export record

Altmetrics

Contributors

Author: Jonathan Barnes
Author: Jennifer Hunter
Author: Steve Harris
Author: Manu Shankar-Hari
Author: Elisabeth Diouf
Author: Ib Jammer
Author: Cor Kalkman
Author: Andrew A. Klein
Author: Tomas Corcoran
Author: Stefan Dieleman
Author: Michael G. Mythen
Author: Paul Myles
Author: Tang Joon Gan
Author: Andrea Kurz
Author: Phil Peyton
Author: Dan Sessler
Author: Martin Tramèr
Author: Alan Cyna
Author: Gildasio S. De Oliveira
Author: Christopher Wu
Author: Mark Jensen
Author: Henrik Kehlet
Author: Mari Botti
Author: Oliver Boney
Author: Guy Haller
Author: Tim Cook
Author: Lee Fleisher
Author: Mark Neuman
Author: David Story
Author: Russell Gruen
Author: Sam Bampoe
Author: Lis Evered
Author: David Scott
Author: Brendan Silbert
Author: Diederik van Dijk
Author: Matthew Chan
Author: Hilary Grocott
Author: Rod Eckenhoff
Author: Lars Rasmussen
Author: Lars Eriksson
Author: Scott Beattie
Author: Duminda Wijeysundera
Author: Giovanni Landoni
Author: Kate Leslie
Author: Bruce Biccard
Author: David James Cooper
Author: Andrew Shaw
Author: Mark Johnson
Corporate Author: the StEP-COMPAC Group

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×