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Trial registered on ANZCTR
Registration number
ACTRN12618000533291
Ethics application status
Approved
Date submitted
14/12/2017
Date registered
10/04/2018
Date last updated
7/07/2020
Date data sharing statement initially provided
26/04/2019
Date results information initially provided
26/04/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
The risk of dementia after sepsis in the Swedish ICU cohort
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Scientific title
The risk of dementia after sepsis in the Swedish ICU cohort
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Secondary ID [1]
293588
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None
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Universal Trial Number (UTN)
U1111-1205-4606
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Dementia ICD10: F00.x–F03.x, F05.1, G30.x, G31.1
305832
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Severe sepsis ICD10: R65.1
305833
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Septic shock ICD10: R57.2
305834
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Sepsis ICD10: A41.9
306690
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Condition category
Condition code
Neurological
305046
305046
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0
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Dementias
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Neurological
305047
305047
0
0
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Alzheimer's disease
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Infection
305048
305048
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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
True
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Target follow-up duration
5.5
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Target follow-up type
Years
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Description of intervention(s) / exposure
The exposure is Intensive Care Unit (ICU) care for sepsis, severe sepsis or septic shock (sepsis) in the Swedish ICU-registry (SIR) between the years 2005 and 2016. Patients will be followed until december 31:st 2016.
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Intervention code [1]
299841
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Diagnosis / Prognosis
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Comparator / control treatment
Patients treated in ICU without sepsis in the Swedish ICU-registry (SIR) between the years 2005 and 2016. Patients will be followed until December 31st 2016
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Control group
Active
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Outcomes
Primary outcome [1]
304207
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The outcome, risk of dementia in survival analysis, will be assessed as per diagnosis in the nation wide Patient registry of the Swedish National board of Health and wellfare. In Sweden it is mandatory to report all hospital care episodes with accompanying diagnoses to the Patient registry. The diagnosis of dementia, used to calcualate the risk of dementia, is thus at the discretion of the caring physician.
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Assessment method [1]
304207
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Timepoint [1]
304207
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From enrolment, participants were assessed daily until death, diagnosis of dementia or censoring at December 31st, 2016.
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Secondary outcome [1]
341256
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Risk factors, before and during ICU treated sepsis, for dementia in a survival analysis.
Risk factors studied are: age, sex, Charlson comorbidity index (CCI), Simplified Acute Physiology Score 3 (SAPS), sepsis severity (sepsis, severe sepsis, septic shock) acute/elective admittance, preceding surgery (acute/elective), type of surgery (according to SAPS3), use of non-invasive ventilation, use of invasive ventilation, use of renal replacement therapy, type of hospital (district hospital, county hospital, University hospital), days in ICU.
CCI is assessed by screening the Patient registry for relevant diagnoses 5 years prior to ICU admittance. The remaining risk factors are extracted from the Swedish ICU registry.
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Assessment method [1]
341256
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Timepoint [1]
341256
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The data is collected daily from 5 years prior to enrolement (comorbidity), at enrolement (age, sex, SAPS3, acute/elective admittance, preceding surgery (acute/elective), type of surgery, type of hospital) and at discharge from ICU (sepsis severity, use of non-invasive ventilation, use of invasive ventilation, use of renal replacement therapy, days in ICU).
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Eligibility
Key inclusion criteria
First episode, per patient, of ICU-care with a diagnosis of sepsis in the SIR.
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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 below 18 years of age.
Already included with an earlier episode of ICU-treated sepsis.
Loss to follow-up: emigration or protected identity.
Dementia prior to, or diagnosed during, ICU episode.
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Both
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Statistical methods / analysis
This is a register study. The SIR includes all but five ICUs in Sweden, hence the sample is all but a few ICU-episodes during the years of 2005 through 2016 in Sweden. Any inpatient diagnoses between January 1:st 2000 and December 31:st 2016 will be retrieved from the Patient registry database of the Swedish national board of helath.
Crude incidence of new dementia diagnosis in ICU-treated patients with sepsis will be explored by survival analysis (Cumulative incidince competing risk, CICR) and the difference to all ICU-treated patients without sepsis will be assessed. An adjusted analysis by a Cox (stratified cause specific hazards) model will also be employed.
Risk factors for dementia before and during ICU care will be assessed by Cox regression (cause specific relative hazard).
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
10/04/2018
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Actual
11/04/2018
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Date of last participant enrolment
Anticipated
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Actual
11/04/2018
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Date of last data collection
Anticipated
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Actual
11/12/2018
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Sample size
Target
200000
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Accrual to date
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Final
210378
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Recruitment outside Australia
Country [1]
9426
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Sweden
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State/province [1]
9426
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Whole country
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Funding & Sponsors
Funding source category [1]
298205
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University
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Name [1]
298205
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Uppsala university, the institution of surgical sciences
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Address [1]
298205
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Akademiska sjukhuset ing 70 1 tr
S751 85 UPPSALA
Sweden
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Country [1]
298205
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Sweden
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Funding source category [2]
298206
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Hospital
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Name [2]
298206
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Landstinget Dalarna, the Center of Clinical Research, CKF
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Address [2]
298206
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Nissers väg 3
S791 82 Falun
Sweden
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Country [2]
298206
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Sweden
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Primary sponsor type
University
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Name
Uppsala university, the institution of surgical sciences
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Address
Head of department Per Hellman
Akademiska sjukhuset ing 70 1 tr
S751 85 UPPSALA
Sweden
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Country
Sweden
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Secondary sponsor category [1]
297305
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None
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Name [1]
297305
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None
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Address [1]
297305
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None
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Country [1]
297305
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299213
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Regional Ethical Review Board in Uppsala
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Ethics committee address [1]
299213
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Regionala etikprövningsnämnden i Uppsala
Box 1964
751 49 UPPSALA
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Ethics committee country [1]
299213
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Sweden
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Date submitted for ethics approval [1]
299213
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27/09/2016
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Approval date [1]
299213
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12/10/2016
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Ethics approval number [1]
299213
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2016/421
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Summary
Brief summary
Intensive care unit treated sepsis, severe sepsis and septic shock are associated with several long term complications from different organs systems. There is evidence of accelerated impairment of cognitive functions when repeated cognitive testing is performed before and after a sepsis period. However it is not known if the cognitive impairment eventually is reflected in an increased frequency of dementia in an age-mixed ICU population. For this reason we wish to explore the incidence of dementia and identify its risk factors in sepsis survivors.
This will be done in the Swedish intensive care cohort defined as all patients with an ICU episode with severe sepsis or septic shock in the Swedish intensive care registry from 2005 to 2016. Diagnosis of dementia will be identified in the Swedish National board of health Patient registry. Patients without a diagnosis of dementia before ICU will be followed from first sepsis to 2016 for a new dementia diagnosis and compared to all ICU/treated patients without severe sepsis or septic shock.
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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
79678
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Dr Bjoern Ahlstroem
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Address
79678
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Björn Ahlström
Falu lasarett
Op/an/iva-kliniken
S791 82 Falun
Sweden
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Country
79678
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Sweden
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Phone
79678
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+46 23 492258
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Fax
79678
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Email
79678
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[email protected]
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Contact person for public queries
Name
79679
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Dr Bjoern Ahlstroem
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Address
79679
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Björn Ahlström
Falu lasarett
Op/an/iva-kliniken
S791 82 Falun
Sweden
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Country
79679
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Sweden
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Phone
79679
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+46 23 492258
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Fax
79679
0
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Email
79679
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[email protected]
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Contact person for scientific queries
Name
79680
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Dr Bjoern Ahlstroem
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Address
79680
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Björn Ahlström
Falu lasarett
Op/an/iva-kliniken
S791 82 Falun
Sweden
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Country
79680
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Sweden
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Phone
79680
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+46 23 492258
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Fax
79680
0
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Email
79680
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Sharing individual participant data is not i complience with the ethical approval.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
Current Study Results
No documents have been uploaded by study researchers.
Update to Study Results
Doc. No.
Type
Is Peer Reviewed?
DOI
Citations or Other Details
Attachment
4688
Study results article
Yes
Ahlström B, Larsson IM, Strandberg G, Lipcsey M. A...
[
More Details
]
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
A nationwide study of the long-term prevalence of dementia and its risk factors in the Swedish intensive care cohort.
2020
https://dx.doi.org/10.1186/s13054-020-03203-y
N.B. These documents automatically identified may not have been verified by the study sponsor.
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