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临床试验/NCT04621539
NCT04621539已完成不适用

Validation of the Quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) Predictive Model in the Prediction of Severe Infection - Sepsis in Obstetric Patients and Adverse Neonatal Outcomes: a Multicenter Study

Fundación Grupo de Investigación en Cuidados Intensivos y Obstetricia1 个研究点 分布在 1 个国家目标入组 2,125 人开始时间: 2018年1月1日最近更新:
适应症

试验速览

阶段
不适用
状态
已完成
发起方
入组人数
2,125
试验地点
1
主要终点
Prolonged ICU stay

研究概览

简要总结

Research problem: In 1991, the terms Systemic Inflammatory Response Syndrome (SIRS), severe sepsis, and septic shock were introduced, based on the pro-inflammatory theory, conforming to a list of classification criteria for each one. New criteria were recently created in search of coherence with the pathophysiological process that generates the infection in the host: SOFA and qSOFA scores. Neither of these two criteria has been standardized in the obstetric patient, taking into account the physiological alteration of many of the clinical and laboratory parameters that occur in pregnancy. The question that arises then is: Are the new sepsis criteria qSOFA and SOFA valid in comparison with the previous SIRS criteria for predicting adverse maternal and neonatal outcomes in obstetric patients diagnosed with infection? Aim: To evaluate the predictive model quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) in comparison with the SIRS criteria for the prognosis of severe infection-sepsis in obstetric patients and adverse neonatal outcomes in different cities of Colombia.

Methodology: a longitudinal prospective cohort multicenter study will be carried out in selected centers in Colombia, with a data collection duration of at least 12 months. Data will be collected on clinical characteristics, health outcomes, and medical practices. Study participants will be followed during their stay at the health center. Follow-up will end at hospital discharge, transfer to a facility outside of participating geographic areas, or death. Neonates born to mothers included in the study will be followed until discharge from the hospital or 7 days after birth if they are still in the hospital, whichever comes first.

Expected results: This study seeks to evaluate the predictive model q SOFA and the prognosis of sepsis in obstetrics in comparison with the SIRS criteria, hoping to find that qSOFA is superior to the SIRS criteria for the identification of which obstetric patients diagnosed with an infection they will progress to sepsis and which patients with sepsis progress to septic shock, this would translate both at the maternal and neonatal level in a reduction of adverse events, prolonged stays, disabilities, sequelae, in addition to allowing preventive actions and control, which finally translate into protocols that allow better management of this entity.

研究设计

研究类型
Observational
观察模型
Cohort
时间视角
Prospective

入排标准

年龄范围
14 Years 至 49 Years(Child, Adult)
性别
Female
接受健康志愿者

入选标准

  • Patients in a state of pregnancy with a single fetus between 14 and 49 years old.
  • Pregnant women (any gestational age) defined as a positive gravindex test and an obstetric ultrasound to prove it.
  • Any suspected or confirmed infection during current hospital stay (primary admission or readmission) with or without organ dysfunction
  • Any clinical signs suggestive of infection (eg, fever)
  • Request for culture of body fluids (blood, urine, cerebrospinal fluid, etc.) or swab specimen (nasopharyngeal, oropharyngeal);
  • Non-prophylactic use of antibiotics or other antimicrobials during admission or during hospital stay.
  • Any health care related infection (eg, surgical site, episiotomy, IV, venipuncture, urinary catheterization, central line, etc.)
  • Urinary tract infection of the lower urinary tract that requires hospitalization and in-hospital management for more than 48 hours.
  • Herpes simplex, herpes zoster (shingles) with associated liver failure.
  • Note: observations on the inclusion criteria:
  • Eligible women who remain in the health center for 12 hours or more, regardless of formal administrative admission, will be included in the study.
  • Eligible women admitted or readmitted to a participating health center, regardless of length of hospital stay, will be included in the study.

排除标准

  • Pregnant women of any age who do not sign the informed consent.
  • Pregnant minors who do not sign the consent.
  • Any non-serious or localized infection
  • Vaginosis, candidiasis
  • Fungal skin infections (athlete's foot, ringworm)
  • Otitis o Pharyngitis
  • Any chronic uncomplicated infection
  • Sexually transmitted infections (gonorrhea, syphilis, Trichomonas, chlamydia, hepatitis, HIV).
  • Tuberculosis.
  • Any colonization Microorganisms without clinical signs / symptoms)
  • Known vaginal, urethral and / or rectal colonization of group B beta-hemolytic streptococcus.
  • Asymptomatic bacteriuria
  • Known oropharyngeal colonization
  • Patients with surgical wound infection other than caesarean section (hysterectomy, laparotomy or others)
  • Any iatrogenic / hyperthermic hypothermia (eg related to epidural, thyroid storm, prostaglandin administration) during hospital stay.
  • Use of any prescription of prophylactic antibiotics (eg, for colonization of beta-hemolytic streptococcus group B, after cesarean section, manual removal of the placenta, vaginal delivery);
  • Patients referred from other institutions with more than 24 hours of management

结局指标

主要结局

Prolonged ICU stay

时间窗: 28 days

Stay in intensive care unit for 72 hours

Admission to intensive care unit

时间窗: 28 days

need or admission to an intensive care unit

Use of vasopressors

时间窗: 28 days

use of vasoactive drugs (norepinephrine, epinephrine, vasopressin)

次要结局

  • Additional interventions(28 days)

研究者

发起方
Fundación Grupo de Investigación en Cuidados Intensivos y Obstetricia
申办方类型
Other
责任方
Sponsor

研究点 (1)

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