- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT02086877
COGnitive Outcomes and WELLness in Survivors of Critical Illness (COGWELL)
As survival rates from critical illness improve, strategies to return patients to their baseline cognitive and functional status are important research priorities. Up to 100% of ICU survivors will suffer some degree of cognitive impairment at hospital discharge and approximately 50% will have decrements that persist for years. While the mechanisms for this newly acquired brain injury are poorly understood, several risk factors have been identified. Unfortunately, it is unclear how to accurately predict long-term cognitive impairment.
Immediate opportunities to improve cognitive outcomes through risk reduction exist. The investigators propose to comprehensively study the prevalence of sleep abnormalities and their association with cognitive impairment, as it may yield potential targets for effective therapy. Moreover, the investigators will examine for gene x environment associations [APOE ε4] that may allow for genetic risk stratification of individuals at greatest risk of cognitive impairment. The investigators hypothesize that EEG [a sensitive longitudinal marker of brain dysfunction] is a novel and independent predictor of long-term cognitive impairment, and possibly a candidate intermediate end point for future clinical trials.
This study has the potential to identify novel biomarkers and risk factors for post-critical illness cognitive impairment, and may lay the foundation for rational interventions to mitigate risk in high-risk individuals.
Aperçu de l'étude
Statut
Les conditions
Type d'étude
Inscription (Anticipé)
Contacts et emplacements
Lieux d'étude
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Ontario
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Toronto, Ontario, Canada, M4N 3M5
- Recrutement
- Sunnybrook Health Sciences Centre
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Toronto, Ontario, Canada, M5G 1X5
- Recrutement
- Mount Sinai Hospital
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Contact:
- Sumesh Shah
- E-mail: Sumesh.Shah@SinaiHealthSystem.ca
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Toronto, Ontario, Canada, M5B 1W8
- Recrutement
- St Michael's Hospital
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Contact:
- Orla Smith
- E-mail: osmith@smh.ca
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Toronto, Ontario, Canada, M5G 2C4
- Recrutement
- University Health Network - Toronto General Hospital
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Contact:
- Andrea Matte
- E-mail: andrea.matte@uhn.ca
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Toronto, Ontario, Canada, M5T 2S8
- Recrutement
- University Health Network - Toronto Western Hospital
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Contact:
- Paulina Farias
- E-mail: paulina.farias@uhn.ca
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
La description
Inclusion Criteria:
- ≥16 years of age
- Admission to study ICU for invasive mechanical ventilation [minimum of 72 hours]
Exclusion Criteria:
- Advanced cognitive impairment or unable to follow simple commands before their acute illness [e.g. end-stage Alzheimer's disease]
- Primary neurological injury [e.g. anoxic brain injury, stroke or traumatic brain injury]
- Anticipated death within 3 months of discharge [e.g. palliative]
- Uncontrolled psychiatric illness at hospital admission
- Not fluent in English
- Unlikely to adhere with follow-up [e.g. no fixed address]
- Residence greater than 300 kms from referral centre
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
Cohortes et interventions
Groupe / Cohorte |
|---|
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ICU Survivors who required > 72 hrs mechanical ventilation
No intervention
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Délai |
|---|---|
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Change in cognitive performance from day 7 after ICU discharge as measured by the Repeatable Battery for the Assessment of Neuropsychological Status [RBANS] and Trail Making Tests A and B
Délai: 7 days, 6-months and 12-months after ICU discharge
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7 days, 6-months and 12-months after ICU discharge
|
Mesures de résultats secondaires
Mesure des résultats |
Délai |
|---|---|
|
Medical Outcomes Study Short Form -36 Questionnaire (SF-36)
Délai: 7 days, 6- and 12-months after ICU discharge
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7 days, 6- and 12-months after ICU discharge
|
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Beck Depression Inventory-II (BDI-II)
Délai: 7 days, 6- and 12-months after ICU discharge
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7 days, 6- and 12-months after ICU discharge
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Richard Campbell Sleep Questionnaire
Délai: 7 days, 6- and 12-months after ICU discharge
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7 days, 6- and 12-months after ICU discharge
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Pittsburgh Sleep Quality Index
Délai: 7 days, 6- and 12-months after ICU discharge
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7 days, 6- and 12-months after ICU discharge
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Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: M Elizabeth Wilcox, Assistant Professor
Publications et liens utiles
Publications générales
- Wilcox ME, McAndrews MP, Van J, Jackson JC, Pinto R, Black SE, Lim AS, Friedrich JO, Rubenfeld GD. Sleep Fragmentation and Cognitive Trajectories After Critical Illness. Chest. 2021 Jan;159(1):366-381. doi: 10.1016/j.chest.2020.07.036. Epub 2020 Jul 24.
- Wilcox ME, Lim AS, McAndrews MP, Wennberg RA, Pinto RL, Black SE, Walczak KD, Friedrich JO, Taglione MS, Rubenfeld GD. A study protocol for an observational cohort investigating COGnitive outcomes and WELLness in survivors of critical illness: the COGWELL study. BMJ Open. 2017 Jul 13;7(7):e015600. doi: 10.1136/bmjopen-2016-015600.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Anticipé)
Achèvement de l'étude (Anticipé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 13-6425-BE
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
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