Long-Term Outcomes After Cardiac Arrest : Protocol for the Extended Follow-Up Sub-Study of the STEPCARE Trial
(2025) In Acta Anaesthesiologica Scandinavica 69(9).- Abstract
Background: The international multi-center randomized controlled STEPCARE-trial will investigate optimal management of sedation, temperature, and mean arterial pressure (MAP) during intensive care in out-of-hospital cardiac arrest (OHCA) patients due to various etiologies. The primary outcome is mortality at 6 months. This protocol describes an extended follow-up sub-study of the STEPCARE-trial with the main objective to provide detailed long-term outcomes for survivors and caregivers. It will focus on potential neuroprotection and improved recovery for different targets of sedation, temperature, and MAP management at 6 and 12 months post-OHCA. Methods: All survivors and one caregiver per survivor at selected STEPCARE sites will be... (More)
Background: The international multi-center randomized controlled STEPCARE-trial will investigate optimal management of sedation, temperature, and mean arterial pressure (MAP) during intensive care in out-of-hospital cardiac arrest (OHCA) patients due to various etiologies. The primary outcome is mortality at 6 months. This protocol describes an extended follow-up sub-study of the STEPCARE-trial with the main objective to provide detailed long-term outcomes for survivors and caregivers. It will focus on potential neuroprotection and improved recovery for different targets of sedation, temperature, and MAP management at 6 and 12 months post-OHCA. Methods: All survivors and one caregiver per survivor at selected STEPCARE sites will be invited to participate. Randomization is stratified by site. This sub-study extends the main STEPCARE follow-up at 6 months by undertaking detailed assessments, face-to-face meetings, inclusion of a caregiver, and repeating the assessments at 12 months. Our main outcome for survivors is cognitive function measured by the Montreal Cognitive Assessment, and for caregivers, the caregiver burden measured by the Zarit Burden Interview. Additional outcomes include symptoms of anxiety, depression, post-traumatic stress disorder, fatigue, physical function, life satisfaction, and life impact (disability), assessed by psychometrically robust measures. The estimated sample size is 600. Efforts to improve interrater reliability and decrease missing data are integral to the study design. Conclusion: These detailed long-term outcomes will explore the possible benefits or risks of fever, sedation, and blood pressure management in post-OHCA survivors. Additionally, this study will explore survivorship after cardiac arrest from various perspectives, including different causes of arrest. ClinicalTrials.gov: NCT0207942.
(Less)
- author
- organization
-
- Neurology, Lund
- Center for cardiac arrest (research group)
- Brain Injury After Cardiac Arrest (research group)
- Anesthesiology and Intensive Care
- SEBRA Sepsis and Bacterial Resistance Alliance (research group)
- Cardiology
- Neurological injury in acute type A aortic dissection (research group)
- Anaesthesiology and Intensive Care Medicine (research group)
- publishing date
- 2025-10
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- caregivers, cognition, follow-up studies, out-of-hospital cardiac arrest, outcomes, randomized controlled trial
- in
- Acta Anaesthesiologica Scandinavica
- volume
- 69
- issue
- 9
- article number
- e70114
- publisher
- Blackwell Munksgaard
- external identifiers
-
- scopus:105014627785
- pmid:40856035
- ISSN
- 0001-5172
- DOI
- 10.1111/aas.70114
- language
- English
- LU publication?
- yes
- id
- 99d1bf0a-3112-432e-82cf-5534b94976f2
- date added to LUP
- 2025-10-10 13:52:58
- date last changed
- 2025-10-11 03:20:23
@article{99d1bf0a-3112-432e-82cf-5534b94976f2, abstract = {{<p>Background: The international multi-center randomized controlled STEPCARE-trial will investigate optimal management of sedation, temperature, and mean arterial pressure (MAP) during intensive care in out-of-hospital cardiac arrest (OHCA) patients due to various etiologies. The primary outcome is mortality at 6 months. This protocol describes an extended follow-up sub-study of the STEPCARE-trial with the main objective to provide detailed long-term outcomes for survivors and caregivers. It will focus on potential neuroprotection and improved recovery for different targets of sedation, temperature, and MAP management at 6 and 12 months post-OHCA. Methods: All survivors and one caregiver per survivor at selected STEPCARE sites will be invited to participate. Randomization is stratified by site. This sub-study extends the main STEPCARE follow-up at 6 months by undertaking detailed assessments, face-to-face meetings, inclusion of a caregiver, and repeating the assessments at 12 months. Our main outcome for survivors is cognitive function measured by the Montreal Cognitive Assessment, and for caregivers, the caregiver burden measured by the Zarit Burden Interview. Additional outcomes include symptoms of anxiety, depression, post-traumatic stress disorder, fatigue, physical function, life satisfaction, and life impact (disability), assessed by psychometrically robust measures. The estimated sample size is 600. Efforts to improve interrater reliability and decrease missing data are integral to the study design. Conclusion: These detailed long-term outcomes will explore the possible benefits or risks of fever, sedation, and blood pressure management in post-OHCA survivors. Additionally, this study will explore survivorship after cardiac arrest from various perspectives, including different causes of arrest. ClinicalTrials.gov: NCT0207942.</p>}}, author = {{Lilja, Gisela and Töniste, Dorit and Bass, Frances and Jakobsen, Janus Christian and Nielsen, Niklas and Skrifvars, Markus B. and Ullén, Susann and Dankiewicz, Josef and Levin, Helena and Hästbacka, Johanna and Knappe, Marion Moseby and Saxena, Manoj and Wise, Matt P. and Young, Paul and Aneman, Anders and Ameloot, Koen and Cole, Jade M. and Cronberg, Tobias and Delaney, Anthony and Druwé, Patrick and During, Joachim and Graf, Tobias and Haenggi, Matthias and Heimburg, Katarina and Itens, Manuela and Barkholt, Caroline Kamp and Keeble, Thomas R. and Leithner, Christoph and Lybeck, Anna and Lundin, Andreas and McGuigan, Peter and Mengel, Annerose and Oksanen, Tuomas and Ridgway, John and Romundstad, Luis and Schrag, Claudia and Stammet, Pascal and Tippett, Anna and Thomas, Matthew and Tirkkonen, Joonas and Undén, Johan and Venkatesh, Bala and Tiainen, Marjaana and Hammond, Naomi}}, issn = {{0001-5172}}, keywords = {{caregivers; cognition; follow-up studies; out-of-hospital cardiac arrest; outcomes; randomized controlled trial}}, language = {{eng}}, number = {{9}}, publisher = {{Blackwell Munksgaard}}, series = {{Acta Anaesthesiologica Scandinavica}}, title = {{Long-Term Outcomes After Cardiac Arrest : Protocol for the Extended Follow-Up Sub-Study of the STEPCARE Trial}}, url = {{http://dx.doi.org/10.1111/aas.70114}}, doi = {{10.1111/aas.70114}}, volume = {{69}}, year = {{2025}}, }