Clinical Trial Details
— Status: Not yet recruiting
Administrative data
NCT number |
NCT06308835 |
Other study ID # |
APHP231652 |
Secondary ID |
|
Status |
Not yet recruiting |
Phase |
|
First received |
|
Last updated |
|
Start date |
May 2024 |
Est. completion date |
August 2025 |
Study information
Verified date |
March 2024 |
Source |
Assistance Publique - Hôpitaux de Paris |
Contact |
Marois Clémence, MD, MSc |
Phone |
0142161858 |
Email |
clemence.marois[@]aphp.fr |
Is FDA regulated |
No |
Health authority |
|
Study type |
Observational
|
Clinical Trial Summary
Post-intensive care syndrome (PICS) is the set of disabling symptoms that can appear or
worsen following a stay in intensive care. These symptoms are physical, cognitive, or
psychiatric. The onset and persistence of these symptoms have a major impact on patients'
quality of life, their autonomy, and their social and professional reintegration. patients
with neurological diseases are frequently excluded from studies due to difficulties for the
non-specialist resuscitator to perform the neurological examination and assess whether the
symptoms of RPS are secondary to brain damage or complications inherent in resuscitation.The
aim of this study is to evaluate the incidence and characteristics of PICS in patients with
neurological diseases, at ICU discharge and 3 months after, and to identify the risk factors
for developing it.
Description:
"Post-intensive care syndrome (PICS) is defined as a new or worsening impairment in physical,
cognitive or mental health status arising and persisting after a stay in intensive care unit
(ICU) . The onset and persistence of these symptoms have a major impact on patients' quality
of life, their autonomy, and their social and professional reintegration. PICS is very
common, and more than half of ICU adult patients experience such impairments.
Recent French guidelines about PICS have been published and implemented to raise awareness
among clinicians and patients about diagnosis and management of PICS .
A systematic ICU follow-up consultation by trained practitioners allows the diagnosis of
PICS, and the implementation of appropriate curative measures to minimize sequelae and
improve outcomes . This consultation is increasingly recommended by learned societies.
Incidence and risk factors of PICS is poorly known in patients with neurological diseases,
because they are frequently excluded from PICS studies due to difficulties to assess whether
the symptoms are disease-related or directly associated with the experience of a critical
illness. A better knowledge of follow up of these patients is necessary to identify if some
neurocognitive sequelae may be preventable or treatable.
The aim of this study is to evaluate the incidence and characteristics of PICS in patients
with neurological diseases, at ICU discharge and 3 months after, and to identify the risk
factors for developing it.
The investigators wish to conduct a bi-centric prospective study, in two neurological ICU in
Paris (AP-HP Sorbonne université - Pitié Salpetrière hospital and Paris Cité -Saint Anne
Hospital). The study will last one year.
It will included adults patients hospitalized >24h in neuro-ICU for a neurological disease
affecting the central nervous system (status epilepticus, encephalitis, subarachnoid
haemorrhage…) or the peripheral nervous system (myasthenia gravis crisis, Guillain-Barre
syndrome…) ; and having received ICU lifesaving treatments (mechanical ventilation; sedation;
plasmapheresis, renal replacement therapy, catecholamine).
Were excluded pregnant women, patients with pre-existing neurodegenerative disease or
pre-existing severe psychiatric illness, and patients whose neurological or psychiatric
history were not known prior to ICU. Patients with blindness, deafness, inability to speak
French, active substance abuse, homelessness, or who lived > 100 kilometers from the
enrolling center.
Patients will be recruited at the end of the ICU stay, patient's non-opposition will be
collected. If the patient is unable to consent, the non-opposition of the person of trust
will be collected.
As close as possible to the ICU discharge, a neurological examination, a MRC score, a MOCA
scale, and a HADS scale will be performed.
The ICU-follow up visit will be planned 3 months +- 30 days from the ICU discharge and will
include:
- An interview conducted by a trained neuro-intensivist with assessment of neurological
symptoms and autonomy assessed by the Glasgow Outcome Scale extended (GOS-e), and the
modified Rankin Scale (mRS), of psychiatric symptoms with self-reported questionnaires:
Hospital Anxiety and Depression Scale (HADS) and the impact of event scale (IES-R).
- A physical assessement by a physiotherapist including a Medical research coucil score
(MRC)
- A neuropsychological assessement by a neuropsychologist including a Montreal Cognitive
Assessment (MOCA), batterie d'efficience frontale (BREF), Symbol Digit Modalities Test
(SDMT), Trail Making Test (TMT), Empans verbaux, Boston naming Test (BNT)