Major Adverse Cardiovascular EventsNCT07692503
How Institutional Guidelines for Urgent Inpatient Surgeries Affect Intensity of Perioperative Cardiovascular Testing
An observational study of Major Adverse Cardiovascular Events and Cardiovascular Testing and Consultation Intensity, run by Johns Hopkins University.
Trial summary
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. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Major Adverse Cardiovascular Events, Cardiovascular Testing and Consultation Intensity
- How many people
- 3,000 participants
- Where
- No sites listed yet
- Study dates
- Dec 2026to Jun 2028
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Adults admitted through the Emergency Department to Johns Hopkins Hospital (JHH) Downtown or JHH Bayview Medical center above the age of 18 who require surgery during the stay.
Who may be able to join
- 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
Who cannot join
- Elective surgeries,
- Outpatient procedures,
- Procedures followed only by observation or extended-stay recovery rather than inpatient admission,
- Patients younger than 18 years old
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: PERLHS: How Institutional Guidelines for Urgent Inpatient Surgeries Affect Intensity of Perioperative Cardiovascular Testing: A PrePost Study
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.
- Keywords
- Perioperative Care, Preoperative Care, Clinical Decision Support Systems, Hospital Medicine, High Value Care, Testing intensity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Cohort 2: Perioperative Cardiovascular Clinical Decision Support | Participants receive standard perioperative care in a health system where an educational clinical decision support tool is available within the Epic electronic health record. The CDS tool provides evidence-informed, multidisciplinary recommendations regarding perioperative cardiovascular testing, specialty consultation, and institutional workflows for urgent inpatient surgery. The tool is advisory only, does not automate orders or replace clinician judgment, and clinicians may override or disregard its recommendations at any time. | |
| Cohort 1: Usual Care | Participants receive standard perioperative evaluation and management according to existing institutional practice prior to implementation of the clinical decision support tool. Clinical decisions regarding cardiovascular testing and specialty consultation are made at the discretion of the treating clinicians without access to the study CDS tool. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Rate of preoperative tests and consult orders
Cardiovascular Testing and Consultative Intensity. Rate of preoperative tests and consult orders per patient per admission.
Measured: From Presentation to the ED to 6 months post presentation
Secondary outcomes (2)
Major Adverse Cardiac Events (MACE)
Major Adverse Cardiac Events (MI, Cerebrovascular Accident, Unstable Arrhythmia, Myocardial Injury after Non-cardiac Surgery (MINS), Sudden Cardiac Death)
Measured: From presentation at the ED to 6 months post presentation
Time to OR
Time from Presentation at the ED to start of Surgery
Measured: 0 hours to 5 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Jul 2026
- Study startDec 2026 (estimated)
- Primary completionDec 2027 (estimated)
- Study completionJun 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Major Adverse Cardiovascular EventsStudies of the same condition, open and under way.
- More trials run by Johns Hopkins UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 3,000 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Johns Hopkins University
- Sponsor type
- University, hospital or other
- Collaborators
- Agency for Healthcare Research and Quality (AHRQ), Patient-Centered Outcomes Research Institute
- Responsible party
- Sponsor
- Investigators
- Phillip Wagner, MD, Principal investigator, Johns Hopkins University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07692503
- Sponsor's protocol ID
- IRB00554070
- Other IDs
- AHRQ-PCORI LHS P30 H5029772
- Status last verified
- Jul 2026
- First submitted
- 2 Jul 2026
- Last updated
- 14 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 14 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- PERLHS: How Institutional Guidelines for Urgent Inpatient Surgeries Affect Intensity of Perioperative Cardiovascular Testing: A PrePost Study
- ClinicalTrials.gov ID
- NCT07692503
- Acronym / sponsor ID
- IRB00554070
- Keywords
- Perioperative Care, Preoperative Care, Clinical Decision Support Systems, Hospital Medicine, High Value Care, Testing intensity
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 3,000 participants (estimated)
- Lead sponsor
- Johns Hopkins UniversityUniversity, hospital or other
- Collaborators
- Agency for Healthcare Research and Quality (AHRQ), Patient-Centered Outcomes Research Institute
- Study start
- Dec 2026 (estimated)
- Primary completion
- Dec 2027 (estimated)
- Study completion
- Jun 2028 (estimated)
- First posted
- 9 Jul 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Cohort 2: Perioperative Cardiovascular Clinical Decision Support | – | –Participants receive standard perioperative care in a health system where an educational clinical decision support tool is available within the Epic electronic health record. The CDS tool provides evidence-informed, multidisciplinary recommendations regarding perioperative cardiovascular testing, specialty consultation, and institutional workflows for urgent inpatient surgery. The tool is advisory only, does not automate orders or replace clinician judgment, and clinicians may override or disregard its recommendations at any time. |
| Cohort 1: Usual Care | – | –Participants receive standard perioperative evaluation and management according to existing institutional practice prior to implementation of the clinical decision support tool. Clinical decisions regarding cardiovascular testing and specialty consultation are made at the discretion of the treating clinicians without access to the study CDS tool. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Adults admitted through the Emergency Department to Johns Hopkins Hospital (JHH) Downtown or JHH Bayview Medical center above the age of 18 who require surgery during the stay.
Key inclusion criteria (2 listed)
- 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
Key exclusion criteria (4 listed)
- Elective surgeries,
- Outpatient procedures,
- Procedures followed only by observation or extended-stay recovery rather than inpatient admission,
- Patients younger than 18 years old
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Rate of preoperative tests and consult orders
Time frame: From Presentation to the ED to 6 months post presentation
Cardiovascular Testing and Consultative Intensity. Rate of preoperative tests and consult orders per patient per admission.
2 secondary outcomes
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
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Jul 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Phillip Wagner, MD principal investigator
Johns Hopkins University
Questions about this trial
What is this clinical trial studying?
An observational study of Major Adverse Cardiovascular Events and Cardiovascular Testing and Consultation Intensity, run by Johns Hopkins University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 14 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Phillip Wagner, MD (14128418522, pwagner6@jh.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Rate of preoperative tests and consult orders (time frame: From Presentation to the ED to 6 months post presentation). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Jul 2026.