Abuse and Addiction in ICU

August 18, 2021 updated by: Jinwoo Lee, Seoul National University Hospital

Effect of Recent Alcohol, Smoking and Psychotropic Drug Use on Delirium in ICU

Investigators are seeking to determine the impact of recent alcohol, smoking or psychotropic drug use prior to intensive care unit (ICU) admission on incidence of delirium and sedation requirements.

Study design: A prospective observational study, in a medical ICU of a tertiary university hospital.

Methods: For all new ICU admissions, a 1-page questionnaire including Alcohol Use Disorders Identification Test (AUDIT-C), smoking history and prior medication use was given to the patient or closest family members.

Delirium was assessed by trained ICU nurses using Intensive Care Delirium Screening Checklist and Richmond Agitation-Sedation Scale.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Anticipated)

200

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

For all new ICU admissions above age of 18 years, except for those who fulfill exclusion criteria

Description

Inclusion Criteria:

  • Patients who are older than 18 years of age
  • New patients admitted to medical ICU for the 1st time during their stay in hospital

Exclusion Criteria:

  • Had history of stroke or other primary neurologic disease
  • GCS ≤ 8 prior to ICU admission
  • Transferred from other ICU (except for emergency ICU stay which is limited to less than 36 hours)
  • Not registered within 24 hours after admission
  • Refused to participate
  • If comatous state persists
  • Delirium assessment is not possible due to newly developed neurologic disease, such as cerebral infarction
  • Medical ICU stay less than 24 hours
  • Readmission to medical ICU

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Cohort
  • Time Perspectives: Prospective

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
AUDIT-C > 4
Significant alcohol use within 1 year prior to ICU admission (AUDIT-C>4)
Other: AUDIT-C
Patients or their proxy/closest family member(s) undergo a comprehensive questionnaire including AUDIT-C about his/her alcohol behavior during last year and will be categorized into two groups: Those with AUDIT-C>4 versus AUDIT-C of 4 or below.
Other Names:
  • Alcohol Use Disorders Identification Test
AUDIT-C <=4
No significant alcohol use within 1 year prior to ICU admission (AUDIT-C: equal or less than 4)
Other: AUDIT-C
Patients or their proxy/closest family member(s) undergo a comprehensive questionnaire including AUDIT-C about his/her alcohol behavior during last year and will be categorized into two groups: Those with AUDIT-C>4 versus AUDIT-C of 4 or below.
Other Names:
  • Alcohol Use Disorders Identification Test
Smoking history positive last year
Who smoke cigarette within 1-year prior to ICU admission
Other: Smoking history
Patients or their proxy/closest family member(s) undergo a comprehensive questionnaire including smoking history during last year and will be categorized into two groups: Current smoker versus ex- or never smoker (we also recorded smoking pack-years to distinguish heavy smokers)
Smoking history negative last year
Who did not smoke cigarette within 1-year prior to ICU admission
Other: Smoking history
Patients or their proxy/closest family member(s) undergo a comprehensive questionnaire including smoking history during last year and will be categorized into two groups: Current smoker versus ex- or never smoker (we also recorded smoking pack-years to distinguish heavy smokers)
Prior psychotropic medication use - yes
Who used psychotropic medication within 1-year prior to ICU admission
Other: Prior psychotropic medication use
Patients or their proxy/closest family member(s) undergo a comprehensive questionnaire including psychotropic medication use prior admission to ICU and will be categorized into two groups: Those who use psychotropic medication versus those who do not use psychotropic medication.
Prior psychotropic medication use - no
Who did not use psychotropic medication within 1-year prior to ICU admission
Other: Prior psychotropic medication use
Patients or their proxy/closest family member(s) undergo a comprehensive questionnaire including psychotropic medication use prior admission to ICU and will be categorized into two groups: Those who use psychotropic medication versus those who do not use psychotropic medication.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Delirium during ICU stay
Time Frame: From date of ICU admission until the date of ICU discharge, whichever came first, assessed up to 3 months
From date of ICU admission until the date of ICU discharge, whichever came first, assessed up to 3 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
ICU length of stay
Time Frame: From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months
From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months
Mortality
Time Frame: From date of ICU admission until the date of death, assessed up to 3 months
Death in MICU
From date of ICU admission until the date of death, assessed up to 3 months
Maximal doses of dexmedetomidine
Time Frame: From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months
From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months
Cumulative dose of dexmedetomidine
Time Frame: From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months
Cumulative dose of dexmedetomidine during the patient's MICU stay
From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months
Cumulative dose of midazolam
Time Frame: From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months
Cumulative dose of midazolam during the patient's MICU stay
From date of ICU admission until the date of first documented discharge from ICU or death, whichever came first, assessed up to 3 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Seoul National University Hospital

Investigators

  • Study Chair: Jinwoo Lee, Professor, Seoul National University Hospital
  • Principal Investigator: Jungsil Lee, M.D., Seoul National University Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

March 1, 2016

Primary Completion (Anticipated)

December 1, 2022

Study Completion (Anticipated)

December 1, 2022

Study Registration Dates

First Submitted

October 11, 2016

First Submitted That Met QC Criteria

October 30, 2016

First Posted (Estimate)

November 1, 2016

Study Record Updates

Last Update Posted (Actual)

August 20, 2021

Last Update Submitted That Met QC Criteria

August 18, 2021

Last Verified

August 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • addiction742

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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