Realities, Expectations and Attitudes to Life Support Technologies in Intensive Care for Octogenarians:
NCT ID: NCT01293708
Last Updated: 2020-12-16
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
1504 participants
OBSERVATIONAL
2009-09-30
2013-02-28
Brief Summary
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Detailed Description
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Our primary research question is:
1. What are the 12-month health-related quality of life (HRQOL), functional status, and survival of patients admitted to ICU who are 80+ years old?
Our secondary research questions are:
2. Which patient characteristics are associated with 12-month HRQOL, functional status, and survival?
3. What is the satisfaction of family members with critical care, as measured by the Family Satisfaction in ICU (FS-ICU 24) instrument?
4. For patients surviving their ICU stay, what is the experience of family members caring for the patient during follow up, as measured by the Caregiver Reaction Assessment (CRA) instrument?
5. For patients who do not survive their ICU stay, what is the family satisfaction with EOL care, as measured using the CANHELP Satisfaction (Bereavement) instrument?
6. What is the health-related financial burden experienced by patients and their caregivers during their initial ICU hospitalization and up to 12 months after the index ICU admission?
7. What is the quality of decision making regarding the goals of care for an 80+ ICU patient?
8. What are the values that influence decisions about the goals of care for this population?
To answer these questions, the investigators are conducting a national, multicentre, cohort study of 800 patients age 80+ years who are admitted to Canadian ICUs. The investigators will follow these patients prospectively for 12 months to measure study outcomes. In addition, using novel instruments that the investigators have already developed and validated, the investigators will follow family members of these patients to document their experience as caregivers, their satisfaction with care of their relatives, and the financial implications of having a critically ill loved one. This quantitative project will be complemented by a separate qualitative study in the community setting to further understand the expectations and attitudes of persons over 80 years of age regarding the use of life sustaining technology. Data emerging from this work will inform important clinical decisions regarding critical care and EOL care for this aged population.
The investigators presume that the short- and long-term mortality of 80+ year olds admitted to Canadian ICUs will be high and that the self-reported health-related quality of life and functional status of survivors after hospital discharge will be low. The investigators anticipate that pre-morbid illnesses and functional status before admission to ICU will correlate with long-term clinical outcomes. The investigators are uncertain as to the psychological and financial burden experienced by families when a loved one is in the ICU and during the recovery phase; our study will be the first to furnish such important information. By using administrative databases to complement information already being collected in this study, the investigators will obtain a better understanding of the healthcare resource utilization and longer term survival of this cohort, and will be better positioned to offer effective ICU and follow-up care for this at-risk patient population.
Conditions
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Keywords
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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Hospital Cohort
All 80+ year old that had had an ICU stay of \>=24 hrs. Followed until hospital d/c
No interventions assigned to this group
Longitudinal Cohort
All 80+ year old that had had an ICU stay of \>=24 hrs. Followed for 12 months
No interventions assigned to this group
Eligibility Criteria
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Inclusion Criteria
* patient is \>=80 years old
* patient is a resident of Canada and has a permanent address in this country
* patient has an eligible family caregiver who has visited the patient at least once within 96 hours of the current ICU admission
Exclusion Criteria
* family caregiver is paid to do so
* family caregivers that do not speak English or French
* previously enrolled
80 Years
ALL
No
Sponsors
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Canadian Institutes of Health Research (CIHR)
OTHER_GOV
Daren K. Heyland
OTHER
Responsible Party
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Daren K. Heyland
Dr. Daren Heyland
Principal Investigators
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Daren Heyland, MD
Role: STUDY_CHAIR
Clinical Evaluation Research Unit,, Kingston General Hospital
Locations
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Peter Lougheed Hospital
Calgary, Alberta, Canada
Foothills Hospital
Calgary, Alberta, Canada
University of Alberta Hospital
Calgary, Alberta, Canada
Royal Alexandra Hospital
Edmonton, Alberta, Canada
Grey Nuns Community Hospital
Edmonton, Alberta, Canada
Royal Columbian Hospital
New Westminster, British Columbia, Canada
Surrey Memorial Hospital
Surrey, British Columbia, Canada
St.Paul's Hospital
Vancouver, British Columbia, Canada
Royal Jubilee Hospital
Vancouver, British Columbia, Canada
Victoria General Hospital
Vancouver, British Columbia, Canada
St. Boniface Hospital
Winnipeg, Manitoba, Canada
Winnipeg Health Sciences Center
Winnipeg, Manitoba, Canada
St. Joseph's Healthcare
Hamilton, Ontario, Canada
Kingston General Hospital
Kingston, Ontario, Canada
Ottawa Hospital
Ottawa, Ontario, Canada
Sunnybrook Health Sciences
Toronto, Ontario, Canada
St. Michaels Hospital
Toronto, Ontario, Canada
Mount Sinai
Toronto, Ontario, Canada
Toronto General Hospital
Toronto, Ontario, Canada
Hospital Maisonneuve-Rosemont
Montreal, Quebec, Canada
Hospital de Sacre-Coeur
Montreal, Quebec, Canada
Departement d'Anesthesie
Québec, Quebec, Canada
Hospital Laval
Québec, Quebec, Canada
Royal University Hospital
Saskatoon, Saskatchewan, Canada
Countries
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References
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Chin-Yee N, D'Egidio G, Thavorn K, Heyland D, Kyeremanteng K. Cost analysis of the very elderly admitted to intensive care units. Crit Care. 2017 May 16;21(1):109. doi: 10.1186/s13054-017-1689-y.
Heyland DK, Garland A, Bagshaw SM, Cook D, Rockwood K, Stelfox HT, Dodek P, Fowler RA, Turgeon AF, Burns K, Muscedere J, Kutsogiannis J, Albert M, Mehta S, Jiang X, Day AG. Recovery after critical illness in patients aged 80 years or older: a multi-center prospective observational cohort study. Intensive Care Med. 2015 Nov;41(11):1911-20. doi: 10.1007/s00134-015-4028-2. Epub 2015 Aug 26.
Heyland D, Cook D, Bagshaw SM, Garland A, Stelfox HT, Mehta S, Dodek P, Kutsogiannis J, Burns K, Muscedere J, Turgeon AF, Fowler R, Jiang X, Day AG; Canadian Critical Care Trials Group; Canadian Researchers at the End of Life Network. The Very Elderly Admitted to ICU: A Quality Finish? Crit Care Med. 2015 Jul;43(7):1352-60. doi: 10.1097/CCM.0000000000001024.
Heyland DK, Dodek P, Mehta S, Cook D, Garland A, Stelfox HT, Bagshaw SM, Kutsogiannis DJ, Burns K, Muscedere J, Turgeon AF, Fowler R, Jiang X, Day AG; Canadian Critical Care Trials Group and Canadian Researchers at End of Life Network (CARENET). Admission of the very elderly to the intensive care unit: family members' perspectives on clinical decision-making from a multicenter cohort study. Palliat Med. 2015 Apr;29(4):324-35. doi: 10.1177/0269216314566060. Epub 2015 Feb 2.
Other Identifiers
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R80
Identifier Type: -
Identifier Source: org_study_id