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Trial registered on ANZCTR
Registration number
ACTRN12612001229864
Ethics application status
Approved
Date submitted
19/11/2012
Date registered
21/11/2012
Date last updated
16/10/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Tissue oxygenation in early sepsis study
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Scientific title
Tissue oxygen saturation as predictor of
organ dysfunction in Emergency Department patients with Sepsis
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Secondary ID [1]
281564
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None
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Universal Trial Number (UTN)
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Trial acronym
Assessing risk in sepsis using tissue oxygen saturation (ARISTOS)
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Sepsis
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Condition category
Condition code
Infection
288195
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0
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Other infectious diseases
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Tissue oxygen saturation (StO2) will be measured non-invasively in the muscles of the hand using near infrared spectroscopy. This gives an estimate of the adequacy of the circulation and may be an early indicator of developing shock. These measurements take a few seconds to perform and will be taken on initial assessment in the Emergency Department and three hours subsequently in patients presenting to the Emergency Department with infections. The aim is to evaluate if StO2 is useful to identify patients who are at risk of deteriorating and developing organ failure in the subsequent days following admission to hospital.
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Intervention code [1]
286086
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Not applicable
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Comparator / control treatment
Observational study.
All participants will have tissue oxygen saturation measurements and be followed for outcome.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Organ failure defined using sequential organ failure assessment (SOFA) score of 2 or more points increase from baseline
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Assessment method [1]
288393
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Timepoint [1]
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Once daily SOFA score up to 72 hours following admission from Emergency Department or discharge/death if earlier
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Primary outcome [2]
288394
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Peak, mean and delta (maximal change from admission) SOFA score
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Assessment method [2]
288394
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Timepoint [2]
288394
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Once daily SOFA score up to 72 hours following admission from Emergency Department or discharge/death if earlier
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Secondary outcome [1]
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Death (all cause) as determined from hospital patient database (which is updated from the state register of Births, Deaths and marriages) hospital medical records or contact with the patients primary care doctor as necessary.
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Assessment method [1]
300038
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Timepoint [1]
300038
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28 days
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Secondary outcome [2]
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Subgroup analysis of organ failure (SOFA score of 2 or more) developing among patients with no organ failure or shock present at enrolment
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Assessment method [2]
300039
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Timepoint [2]
300039
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Once daily SOFA score up to 72 hours following admission from Emergency Department or discharge/death if earlier
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Secondary outcome [3]
300040
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Subgroup analysis of peak, mean and delta SOFA score among patients with organ failure/shock present at enrolment
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Assessment method [3]
300040
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Timepoint [3]
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Once daily SOFA score up to 72 hours following admission from Emergency Department or discharge/death if earlier
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Eligibility
Key inclusion criteria
Suspected or proven infection plus 2 or more of (i) temperature >38 of <36 degrees celsius (ii) heart rate >90bpm (iii) respiratory rate >20/min (iv) total white blood count >12x109/L or <4x109/L, and being admitted to hospital for intravenous antibiotics.
Patients will be included if they meet criteria for uncomplicated sepsis, severe sepsis (associated with organ dysfunction) and/or septic shock. Criteria for severe sepsis or septic shock as follows:
Case definition for sepsis as above PLUS either -
1. Organ failure defined as SOFA score of 2 or more e.g. acute respiratory failure, renal failure, or altered mental state
2. Shock defined as (a)systolic blood pressure (SBP) <90mmHg, or mean arterial pressure (MAP)<65mmHg or heart rate >SBP (shock index >1) despite 20-30ml/kg isotonic fluid bolus or (b) serum lactate >4mmol/L.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Age <18 years
Expected to die from other cause (e.g. malignancy) within 90 days
Diagnosed significant chronic cognitive impairment (MMSE<21)
Not for resuscitation order
Intravenous antibiotics prior to presentation
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
27/11/2012
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Actual
5/12/2012
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Date of last participant enrolment
Anticipated
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Actual
13/06/2016
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Date of last data collection
Anticipated
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Actual
19/12/2016
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Sample size
Target
300
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Accrual to date
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Final
323
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Recruitment in Australia
Recruitment state(s)
QLD,WA
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Recruitment hospital [1]
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Armadale Kelmscott Memorial Hospital - Armadale
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Recruitment hospital [2]
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Royal Perth Hospital - Perth
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Recruitment hospital [3]
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The Prince Charles Hospital - Chermside
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Armadale Health Service
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Address [1]
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PO Box 460
Armadale WA 6992
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Country [1]
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Australia
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Funding source category [2]
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Hospital
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Name [2]
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Royal Perth Hospital
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Address [2]
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GPO Box 2213
Perth WA 6000
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Country [2]
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Australia
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Primary sponsor type
University
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Name
University of Western Australia
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Address
35 Stirling Highway
Crawley WA 6009
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
285137
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Address [1]
285137
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Country [1]
285137
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288429
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South Metropolitan Health Service Human Research Ethics Committee
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Ethics committee address [1]
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Fremantle Hospital PO Box 480 Fremantle WA 6959
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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20/06/2012
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Approval date [1]
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16/10/2012
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Ethics approval number [1]
288429
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1/12/0241
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Summary
Brief summary
Severe sepsis accounts for significant morbidity and mortality in the community and is a large contributor to healthcare costs. The hallmark of severe sepsis is organ failure or shock. Patients with community acquired sepsis are initially assessed in the Emergency Department (ED). The signs of early organ dysfunction or shock may not be present when the patient is seen in in the ED, leading to delayed treatment and increased costs. This study will investigate a new technique to measure tissue oxygenation (StO2) non-invasively called near-infrared spectroscopy (NIRS) using a commercially available device. StO2 is a measure of impaired circulation and may be an early indicator of developing shock. We will measure StO2 in the ED in patients who are being admitted to hospital with sepsis. The study hypothesis is that StO2 is associated with organ failure and so can be used to identify patients at risk in this setting. We aim to recruit 300 patients presenting to two metropolitan Emergency departments in Western Australia during this study. This study is investigator initiated and has been designed and funded independently from the manufacturer of the NIRS device or any other industry sponsor.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Stephen Macdonald
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Address
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Centre for Clinical research in Emergency Medicine
Harry Perkins Institute of Medical Research
Royal Perth Hospital
GPO Box X2213
Perth WA 6000
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Country
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Australia
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Phone
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+61 8 9224 8458
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Stephen Macdonald
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Address
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Emergency Medicine
University of Western Australia, Armadale Health Service
PO Box 460
Armadale WA 6992
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Country
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Australia
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Phone
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+61 8 9391 2599
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Stephen Macdonald
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Address
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Emergency Medicine
University of Western Australia, Armadale Health Service
PO Box 460
Armadale WA 6992
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Country
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Australia
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Phone
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+61 8 9391 2599
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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