Abstract:
BACKGROUND:Intensivists' clinical decision making pursues two main goals for patients: to decrease mortality and to improve quality of life and functional status in survivors. Patient-important outcomes are gaining wide acceptance in most fields of clinical research. We sought to systematically review how well patient-important outcomes are reported in published randomized controlled trials (RCTs) in critically ill patients. METHODS:Literature search was conducted to identify eligible trials indexed from January to December 2013. Articles were eligible if they reported an RCT involving critically ill adult patients. We excluded phase II, pilot and physiological crossover studies. We assessed study characteristics. All primary and secondary outcomes were collected, described and classified using six categories of outcomes including patient-important outcomes (involving mortality at any time on the one hand and quality of life, functional/cognitive/neurological outcomes assessed after ICU discharge on the other). RESULTS:Of the 716 articles retrieved in 2013, 112 RCTs met the inclusion criteria. Most common topics were mechanical ventilation (27%), sepsis (19%) and nutrition (17%). Among the 112 primary outcomes, 27 (24%) were patient-important outcomes (mainly mortality, 21/27) but only six (5%) were patient-important outcomes besides mortality assessed after ICU discharge (functional disability = 4; quality of life = 2). Among the 598 secondary outcomes, 133 (22%) were patient-important outcomes (mainly mortality, 92/133) but only 41 (7%) were patient-important outcomes besides mortality assessed after ICU discharge (quality of life = 20, functional disability = 14; neurological/cognitive performance = 5; handicap = 1; post-traumatic stress = 1). Seventy-three RCTs (65%) reported at least one patient-important outcome but only 11 (10%) reported at least one patient-important outcome besides mortality assessed after ICU discharge. CONCLUSION:Patient-important outcomes are rarely primary outcomes in RCTs in critically ill patients published in 2013. Among them, mortality accounted for the majority. We promote the use of patient-important outcomes in critical care trials.
journal_name
Ann Intensive Carejournal_title
Annals of intensive careauthors
Gaudry S,Messika J,Ricard JD,Guillo S,Pasquet B,Dubief E,Boukertouta T,Dreyfuss D,Tubach Fdoi
10.1186/s13613-017-0243-zsubject
Has Abstractpub_date
2017-12-01 00:00:00pages
28issue
1issn
2110-5820pii
10.1186/s13613-017-0243-zjournal_volume
7pub_type
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journal_title:Annals of intensive care
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journal_title:Annals of intensive care
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journal_title:Annals of intensive care
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journal_title:Annals of intensive care
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doi:10.1186/s13613-015-0086-4
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abstract:UNLABELLED: BACKGROUND:A history of prolonged and excessive consumption of alcohol increases the risk for infections. The goal of this study was to investigate circulating white blood cells (WBC) differentiated by flow cytometry and neutrophil CD64 expression in excessive alcohol drinkers versus abstinent or moderate ...
journal_title:Annals of intensive care
pub_type: 杂志文章
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abstract::The death of a loved one is often an ordeal and a tragedy for those who witness it, as death is not merely the end of a life, but also the end of an existence, the loss of a unique individual who is special and irreplaceable. In some situations, end-of-life signs, such as agonal gasps, can be an almost unbearable "sig...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
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abstract:BACKGROUND:Many maneuvers assessing fluid responsiveness (minifluid challenge, lung recruitment maneuver, end-expiratory occlusion test, passive leg raising) are considered as positive when small variations in cardiac index, stroke volume index, stroke volume variation or pulse pressure variation occur. Pulse contour a...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0590-z
更新日期:2019-10-11 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-S1-S1
更新日期:2012-07-05 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2012-06-12 00:00:00
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pub_type: 杂志文章
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更新日期:2020-10-16 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0250-0
更新日期:2017-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-03-26 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0362-1
更新日期:2018-01-30 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2017-12-19 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0506-y
更新日期:2019-02-13 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0309-y
更新日期:2017-08-30 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0576-x
更新日期:2019-09-13 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2017-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2012-07-05 00:00:00
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pub_type: 杂志文章
doi:10.1186/s13613-018-0382-x
更新日期:2018-03-13 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-1-27
更新日期:2011-07-19 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2021-01-13 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2020-09-30 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2013-02-15 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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abstract::This review examines the available evidence for targeting a specific mean arterial pressure (MAP) in sepsis resuscitation. The clinical data suggest that targeting an MAP of 65-70 mmHg in patients with septic shock who do not have chronic hypertension is a reasonable first approximation. Whereas in patients with chron...
journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2015-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2018-08-15 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2018-12-07 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2014-11-25 00:00:00