Valutazione della scala di fragilità clinica (CFS) come fattore di rischio di mortalità in pazienti adulti ≤65 anni ricoverati in terapia intensiva per shock settico. (Woodstock)
The aim of the study is to demonstrate that "frail" patients, defined as having a CFS score greater than or equal to 5, and "severely" frail patients, defined as having a CFS score between [6-7] as defined by Bagshaw et al (14), constitute an independent risk factor (RF) for mortality.
In the same way, as an exploratory study, we will try to find out whether clinical frailty constitutes a risk factor for extending the length of hospital stay, the risk of short/medium-term readmission, as has already been demonstrated for patients admitted to intensive care from all causes (15), or for impaired quality of life.
The objective is to have a better understanding of the implications and outcomes associated with pre-hospital frailty in young critically ill patients.
This analysis will also help to clarify prognoses and contribute to better decision-making on the intensity and proportionality of care, as well as providing better information and helping to manage the expectations of patients and their families in terms of survival prognosis and subsequent quality of life.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Descrizione dettagliata
Recent studies show the impact of frailty in a middle-aged or even young population of patients admitted to critical care in terms of mortality (13), and the persistent risk of impairment of physical and mental capacities after resuscitation (14). To date, few studies have looked at clinical frailty as a risk factor for mortality in a middle-aged or young population, more specifically those suffering from septic shock, which is already known to be a major factor in morbidity and mortality (15,16), with repercussions on long-term quality of life.
The aim of the study is to demonstrate that "frail" patients, defined as having a CFS score greater than or equal to 5, and "severely" frail patients, defined as having a CFS score between [6-7] as defined by Bagshaw et al (14), constitute an independent risk factor (RF) for mortality.
In the same way, as an exploratory study, we will try to find out whether clinical frailty constitutes a risk factor for extending the length of hospital stay, the risk of short/medium-term readmission, as has already been demonstrated for patients admitted to intensive care from all causes (15), or for impaired quality of life.
The objective is to have a better understanding of the implications and outcomes associated with pre-hospital frailty in young critically ill patients.
This analysis will also help to clarify prognoses and contribute to better decision-making on the intensity and proportionality of care, as well as providing better information and helping to manage the expectations of patients and their families in terms of survival prognosis and subsequent quality of life.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: MELANIE VERLAY
- Numero di telefono: 03.21.69.10.28
- Email: mverlay@ch-lens.fr
Backup dei contatti dello studio
- Nome: Guillaume DEGOUY, Dr
- Numero di telefono: 03.21.69.12.34
- Email: gdegouy@ch-lens.fr
Luoghi di studio
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Boulogne-sur-Mer, Francia, 62321
- Reclutamento
- CH Boulogne sur Mer
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Investigatore principale:
- Charles DETOLLENAERE, Dr
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Béthune, Francia, 62408
- Reclutamento
- Ch Germon Et Gauthier
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Investigatore principale:
- Ghada SBOUI, Dr
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Dijon, Francia, 21079
- Reclutamento
- CHU de Dijon
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Investigatore principale:
- Jean-Pierre QUENOT, Pr
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Lens, Francia
- Reclutamento
- CH de Lens
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Investigatore principale:
- Guillaume DEGOUY, Doctor
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Lille, Francia, 59037
- Reclutamento
- CHU Lille
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Investigatore principale:
- Alexandre GAUDET, Dr
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Metodo di campionamento
Popolazione di studio
All patients admitted to intensive care will be studied for this study. Patients meeting the inclusion criteria and with no non-inclusion criteria will be included in the study after obtaining the patient's or relative's, if applicable, non-objection.
Descrizione
Inclusion Criteria:
- Patients aged ≥18 years and ≤ 65 years
- Patient admitted to intensive care - resuscitation
- Patient admitted for suspected or documented type 3 sepsis
- Presence of vasopressor amines to maintain MAP > 65mmHg despite filling
- Lactatemia ≥ 2 mmol/L on admission.
Exclusion Criteria:
- Patient moribund on admission
- Patients with severe pre-existing dementia and/or cognitive decline, suffering from severe neurodegenerative diseases that prevent the patient from living independently at baseline, including mental illness requiring institutionalisation, including acquired or congenital mental retardation, etc.
- Pregnant women or women in labour
- Patients under guardianship or curatorship
- Patients deprived of their liberty
- Patient and/or family unable to speak or understand French.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Modelli osservazionali: OTHER
- Prospettive temporali: PROSPECTIVE
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
To show that the frailty score on admission is a risk factor for mortality at D28, independent of known risk factors, in young patients admitted to intensive care (ICU) for sepsis or septic shock.
Lasso di tempo: 28 days after inclusion
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The odds ratio of frail patients to non-frail patients for the risk of all-cause death at D28 |
28 days after inclusion
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
To study the association, independently of known risk factors, between the frailty score on admission and mortality at day 90.
Lasso di tempo: 90 days after inclusion
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Time from admission to death or last news, censored at D90 |
90 days after inclusion
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To study the association, independently of known risk factors, between the frailty score on admission and length of hospital stay
Lasso di tempo: 90 days after inclusion
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The time between admission to IS and live discharge from hospital, death is considered a concurrent risk, the data are censored at 90 days |
90 days after inclusion
|
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To study the association, independently of known risk factors, between the frailty score on admission and the number of days with recourse to invasive therapies
Lasso di tempo: 90 days after inclusion
|
Number of days with mechanical ventilation, with amines, with recourse to extra-renal purification (EER) during the IS stay. |
90 days after inclusion
|
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To study the association, independently of known risk factors, between the frailty score on admission and readmission to critical care or hospitalisation before D90, among patients discharged alive from ICU before D90.
Lasso di tempo: 90 days after inclusion
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Readmission to critical care or hospitalisation before D90, among patients discharged alive from ICU before D90. |
90 days after inclusion
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To study the association, independently of known risk factors, between the frailty score on admission and describe changes in frailty between ICU admission and D90 in patients alive at D90.
Lasso di tempo: 90 days after inclusion
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Change in frailty score defined by the CFS (continuous) between admission and D90 (in hospital or at home). |
90 days after inclusion
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To study the association, independently of known risk factors, between the frailty score on admission and describe quality of life at D90 in patients alive at D90.
Lasso di tempo: 90 days after inclusion
|
Quality of life measured by the EQ5D score at D90 (in hospital or at home). |
90 days after inclusion
|
Collaboratori e investigatori
Sponsor
Sponsor
Collaboratori
Collaboratori
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- 2023-02
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