Critical Care Observation of Motor Activity (COMA) and SICU Outcomes

Massachusetts General Hospital761 enrolled

Overview

In the surgical intensive care unit (SICU), goals of critical care are often discussed in long-term ventilated patients around the time of extubation. Muscle weakness predicts extubation failure but formal muscle strength assessment by the Medical Research Council scale is time-consuming and not part of the daily clinical exam. In this observational study, we hypothesize that COMA measurement, routinely used by the SICU nurses, is a reliable and valid predictor for patients' SICU outcomes. This prospective observational study is carried out within a consecutively enrolled cohort of adult patients who are extubated in two SICUs at Massachusetts General Hospital, Boston.

Study Type

OBSERVATIONAL

Enrollment

761

Conditions

Motor Activity Muscle Strength Muscle Weakness

Interventions

COMA Score Assessment

Eligibility

Sex: ALLMin age: 18 YearsMax age: 112 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Intubated and mechanically ventilated patients in 2 ICUs at Massachusetts General Hospital * adult patients Exclusion Criteria: * Tracheostomy without extubation attempt * Death without extubation attempt/terminal extubation

Outcomes

Primary Outcomes

Adverse discharge disposition

Time frame: Within one day after hospital discharge

Secondary Outcomes

ICU length of stay

Time frame: Time frame within 24 hours after ICU admission and within 24 hours after ICU discharge

Hospital length of stay

Time frame: Time frame within 24 hours after hospital admission and within 24 hours after hospital discharge

30-day mortality

Time frame: Within 30-days after extubation in the ICU or until the day of hospital discharge

Hospital costs

Time frame: Between the day of hospital admission and the day of hospital discharge

30-day hospital readmission

Time frame: Within 30 days after discharge from the index hospital stay