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ICU Delirium: a One-week Snapshot of Burden Across the Eastern UK Region

17. juli 2013 opdateret af: Papworth Hospital NHS Foundation Trust

ICU delirium negatively impacts on patient outcomes, as well as on resources and clinical workflow of the ICU. Effective healthcare resource planning requires reliable (i.e., multicentre) data that can inform on both of these.

The purpose of this study was to determine the impact of ICU delirium in terms of both patients and beds. The study was carried out prospectively, over a one-week period, at adult ICUs comprising the Norfolk, Suffolk, and Cambridgeshire Critical Care Network (NSC CCN).

Studieoversigt

Status

Afsluttet

Betingelser

Detaljeret beskrivelse

Previous delirium prevalence research has been carried out at single sites and yielded highly variable results (between 3-87%). Reliable multisite data can be obtained cost-effectively using a point-prevalence ("snapshot") approach.

Purpose: to obtain reliable data informing on prevalence of ICU delirium, in terms of both patients and beds, across the eastern UK region.

Design and Setting: this one-week observational prospective cohort study was carried out between June 25, 2012 (start of ICU day shift) to July 01, 2012 (end of night shift). Nine ICUs comprising the Norfolk, Suffolk, and Cambridgeshire Critical Care Network (NSC CCN) took part. Cambridgeshire 2 Research Ethics Committee approved the study (REC reference: 10/H0308/116) and waived the need for informed consent.

Patients and procedure: All adults treated over the study week at participating ICUs were considered eligible for inclusion. Delirium screening was carried out by patients' direct care clinicians using the Confusion Assessment Method for the ICU (CAM-ICU). All sites used this tool as part of their routine clinical practice and had delirium management guidelines in place at the time of the study. Patients who screened positive for delirium were treated according to local hospital practice.

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

225

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Det Forenede Kongerige
    • Cambridgeshire
      • Cambridge, Cambridgeshire, Det Forenede Kongerige, CB23 5EF
        • Papworth Hospital NHS Foundation Trust

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Sandsynlighedsprøve

Studiebefolkning

Adult critically ill patients across eastern UK region

Beskrivelse

Inclusion Criteria:

  • Adult patients treated within study time frame on Intensive Care Units across Norfolk, Suffolk, and Cambridgshire, UK

Exclusion Criteria:

-

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Adult critically ill patients
All adult patients treated within study time frame on Intensive Care Units across Norfolk, Suffolk, and Cambridgshire, UK

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Delirium prevalence
Tidsramme: June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Number of patients with at least one recorded delirium-positive result, over total number of patients recorded over study time frame. Delirium screening will be carried out using the CAM-ICU by local direct care clinicians in accordance with region-wide clinical delirium-screening guidelines.
June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Proportion of patient-days with delirium
Tidsramme: June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Number of patient-days with at least one recorded delirium-positive result over total patient-days recorded.
June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Median delirium duration
Tidsramme: June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
In delirium patients: median number of days recorded with delirium over study time frame.
June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Median days to transition to delirium
Tidsramme: June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
In delirium patients admitted during study time frame: median number of days from ICU admission to first recorded delirium day.
June 25, 2012 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Patient age, by delirium status
Tidsramme: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
In delirium patients versus patients with no recorded delirium-positive result over study time frame: median age.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Patient gender, by delirium status
Tidsramme: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
In delirium patients versus patients with no recorded delirium-positive result over study time frame: number of males over total patients in each group.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Admission type, by delirium status
Tidsramme: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
In delirium patients versus patients with no recorded delirium-positive result over study time frame: number of (1) urgent/emergency and (2) elective admissions, over total patients in each group.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Admission reason, by delirium status
Tidsramme: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
In delirium patients versus patients with no recorded delirium-positive result over study time frame: number of (1) medical and (2) surgical admissions, over total patients in each group.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Organ support, by delirium status
Tidsramme: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
In delirium patients versus patients with no recorded delirium-positive result over study time frame: number receiving advanced and basic respiratory, advanced and basic cardiovascular, and renal support since ICU admission to end of study time frame, over total patients in each group.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Mobilisation therapy, by delirium status
Tidsramme: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
In delirium patients versus patients with no recorded delirium-positive result over study time frame: number receiving mobilisation therapy over study time frame, over total patients in each group.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Median ICU days, by delirium status
Tidsramme: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
In delirium patients versus patients with no recorded delirium-positive result over study time frame: median number of patient-days in ICU per patient, since admission to end of study time frame.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Delirium screening compliance
Tidsramme: June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)
Number of patient-days CAM-ICU administered (1) once or more and (2) twice or more, over total number of patient-days recorded over study time frame.
June 25 (start of ICU day shift) to July 1, 2012 (end of ICU night shift)

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Papworth Hospital NHS Foundation Trust

Samarbejdspartnere

Norfolk, Suffolk, and Cambridgeshire Critical Care Network (NSC CCN)

Efterforskere

  • Ledende efterforsker: Alain Vuylsteke, MD, Papworth Hospital NHS Foundation Trust

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. juni 2012

Primær færdiggørelse (Faktiske)

1. juli 2012

Studieafslutning (Faktiske)

1. juli 2012

Datoer for studieregistrering

Først indsendt

15. juli 2013

Først indsendt, der opfyldte QC-kriterier

17. juli 2013

Først opslået (Skøn)

18. juli 2013

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

18. juli 2013

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

17. juli 2013

Sidst verificeret

1. juli 2013

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • P01535

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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