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.
研究概览
地位
条件
研究类型
注册 (预期的)
联系人和位置
学习地点
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Ontario
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Toronto、Ontario、加拿大、M4N 3M5
- 招聘中
- Sunnybrook Health Sciences Centre
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Toronto、Ontario、加拿大、M5G 1X5
- 招聘中
- Mount Sinai Hospital
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接触:
- Sumesh Shah
- 邮箱:Sumesh.Shah@SinaiHealthSystem.ca
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Toronto、Ontario、加拿大、M5B 1W8
- 招聘中
- St Michael's Hospital
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接触:
- Orla Smith
- 邮箱:osmith@smh.ca
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Toronto、Ontario、加拿大、M5G 2C4
- 招聘中
- University Health Network - Toronto General Hospital
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接触:
- Andrea Matte
- 邮箱:andrea.matte@uhn.ca
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Toronto、Ontario、加拿大、M5T 2S8
- 招聘中
- University Health Network - Toronto Western Hospital
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接触:
- Paulina Farias
- 邮箱:paulina.farias@uhn.ca
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
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
学习计划
研究是如何设计的?
设计细节
队列和干预
团体/队列 |
|---|
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ICU Survivors who required > 72 hrs mechanical ventilation
No intervention
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研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
|---|---|
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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
大体时间:7 days, 6-months and 12-months after ICU discharge
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7 days, 6-months and 12-months after ICU discharge
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次要结果测量
结果测量 |
大体时间 |
|---|---|
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Medical Outcomes Study Short Form -36 Questionnaire (SF-36)
大体时间: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)
大体时间: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
大体时间: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
大体时间: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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合作者和调查者
调查人员
- 首席研究员:M Elizabeth Wilcox、Assistant Professor
出版物和有用的链接
一般刊物
- 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.
研究记录日期
研究主要日期
学习开始
初级完成 (预期的)
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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