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Trial registered on ANZCTR
Registration number
ACTRN12618001816246
Ethics application status
Approved
Date submitted
1/11/2018
Date registered
7/11/2018
Date last updated
21/06/2021
Date data sharing statement initially provided
7/11/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
An audit of nutrition practices in critically ill trauma patients with or without head injury
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Scientific title
An audit of nutrition practices in trauma patients with or without head injury over time
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Secondary ID [1]
296493
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None
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Universal Trial Number (UTN)
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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:
Trauma
310274
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Critically ill
310275
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Head Trauma
310276
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Condition category
Condition code
Diet and Nutrition
309010
309010
0
0
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Other diet and nutrition disorders
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Injuries and Accidents
309036
309036
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0
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Other injuries and accidents
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Public Health
309037
309037
0
0
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Health service research
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
The nutritional prescription and delivery practices of critically ill patients admitted to ICU at the RAH will be reviewed. Nutritional data will be collected for patients admitted to ICU during 2005-2006 and 2018-2019.
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Intervention code [1]
312813
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
307966
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To evaluate the change in total energy (kcal/day) delivery between two cohorts of critically ill trauma patients admitted to the RAH ICU in 2005 and 2019. Assessed by the dietitian prescription's in medical records as well as ICU charts with actual feed received.
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Assessment method [1]
307966
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Timepoint [1]
307966
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For length of ICU stay
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Secondary outcome [1]
353517
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To evaluate differences in calorie prescription between critically ill trauma patients with and without a head injury during 2005 and 2006, and between 2005 and 2019. Assessed by the dietitian prescription's in medical records as well as ICU charts with actual feed received. Actual calories and protein received will be calculated from the specific formula received.
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Assessment method [1]
353517
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Timepoint [1]
353517
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For length of ICU stay
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Secondary outcome [2]
353518
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To evaluate differences in calorie delivery between critically ill trauma patients with and without a head injury during 2005 and 2006, and between 2005 and 2019. Assessed by the dietitian prescription's in medical records as well as ICU charts with actual feed received. Actual calories received will be calculated from the specific formula received.
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Assessment method [2]
353518
0
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Timepoint [2]
353518
0
For length of ICU stay
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Secondary outcome [3]
353519
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To evaluate differences in protein prescription between critically ill trauma patients with and without a head injury during 2005 and 2006, and between 2005 and 2019. Assessed by the dietitian prescription's in medical records as well as ICU charts with actual feed received. Actual protein received will be calculated from the specific formula received.
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Assessment method [3]
353519
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Timepoint [3]
353519
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For length of ICU stay
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Secondary outcome [4]
353520
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To evaluate differences in protein delivery between critically ill trauma patients with and without a head injury during 2005 and 2006, and between 2005 and 2019. Assessed by the dietitian prescription's in medical records as well as ICU charts with actual feed received. Actual protein received will be calculated from the specific formula received.
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Assessment method [4]
353520
0
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Timepoint [4]
353520
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For length of ICU stay
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Eligibility
Key inclusion criteria
Cohort 1:
Trauma without head injury
• Admitted to RAH ICU from February 2005 to December 2006
• Aged >=18 years old
• Received enteral nutrition
• No head injury defined as:
I. ICD-10 codes S10-S99 and T00-T98 ICD-10 codes S10-S99 (Injuries to neck, thorax, abdomen, lower back, lumbar spine, pelvis, shoulder, upper arm, elbow and forearm, wrist and hand, hip and thigh, knee and lower leg, ankle and foot) and T00-T98 (multiple body regions, unspecified trunk, limb or body region, effects of foreign body entering through natural orifice, burns and corrosion's, frostbite, poisoning, toxic effects, unspecified from external causes, early complications from trauma, complications of surgery and medical care, sequelae of injuries)
II. Absence of alterations in brain function or pathology
Trauma with head injury
• Admitted to RAH ICU from February 2005 to December 2006
• Aged >=18 years old
• Received enteral nutrition
• Head injury defined as
I. ICD-10 codes S00-S09 (as above)
II. Any alteration in brain function or pathology
Cohort 2:
Trauma without head injury
• Admitted to RAH ICU from September 2018 onwards
• Aged >=18 years old
• Receiving enteral nutrition
• No head injury defined as:
I. ICD-10 codes S10-S99 and T00-T98 (as above)
II. Absence of alterations in brain function or pathology
Trauma with head injury
• Admitted to RAH ICU from September 2018 onwards
• Aged >=18 years old
• Receiving enteral nutrition
• Head injury defined as
I. ICD-10 codes S00-S09 (as above)
II. Any alteration in brain function or pathology
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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
Not applicable
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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 an exploratory practice audit and hence no power calculation was conducted. Cohort 1 includes 127 patients for which data was collected in a prospective manner as part of a clinical audit over an 18 month time-period from February 2005. Cohort 2 will include prospectively collected patient data from 2018 onwards to match cohort 1, hence including 127 patients.
Continuous variables will be summarised with mean and standard deviation, or median and interquartile range, as appropriate. Categorical variables will be presented as n (%). Patient demographics will be compared between cohorts using t-tests or Mann-Whitney tests for continuous variables, and chi-square or Fishers Exact Test for categorical variables. The primary outcome of mean total delivered calories (kcal/day) will be compared between the two cohorts using an independent samples t-test for an unadjusted analysis, and in a multiple linear regression including cohort and baseline characteristics (age, sex, APACHE-II score at ICU admission) to control for any differences in patient demographics over time. Secondary energy and protein outcomes will be analysed for differences between cohorts and patients with and without head injuries via a linear model with fixed effects for cohort and head injury (Y/N) and tested with planned contrasts. Statistical significance will be assessed at p < 0.05.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
12/11/2018
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Actual
13/12/2018
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Date of last participant enrolment
Anticipated
30/11/2020
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Actual
21/09/2020
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Date of last data collection
Anticipated
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Actual
30/09/2020
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Sample size
Target
254
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Accrual to date
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Final
224
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
12323
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The Royal Adelaide Hospital - Adelaide
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Recruitment postcode(s) [1]
24561
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5000 - Adelaide
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Funding & Sponsors
Funding source category [1]
301080
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Hospital
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Name [1]
301080
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Intensive Care Unit Research Department Royal Adelaide Hospital
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Address [1]
301080
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Royal Adelaide Hospital, Port Road, South Australia, Adelaide, 5000
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Country [1]
301080
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Australia
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Primary sponsor type
Hospital
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Name
Royal Adelaide Hospital
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Address
Royal Adelaide Hospital, Port Road, South Australia, Adelaide, 5000
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Country
Australia
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Secondary sponsor category [1]
300690
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None
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Name [1]
300690
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Address [1]
300690
0
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Country [1]
300690
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
301833
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Central Adelaide Local Health Network HREC EC00192
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Ethics committee address [1]
301833
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Ground Floor, Basil Hetzel Institute for Translational Research 28 Woodville Road, Woodville SA Australia 5000
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Ethics committee country [1]
301833
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Australia
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Date submitted for ethics approval [1]
301833
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29/10/2018
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Approval date [1]
301833
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11/10/2018
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Ethics approval number [1]
301833
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Summary
Brief summary
Enteral nutrition (EN), delivered via a tube into the stomach, provided to critically ill patients is largely inadequate, resulting in muscle wasting and reduced physical function in the long-term. Numerous factors are known to influence nutrition delivery in the intensive care unit (ICU) such as interruptions for procedures, delayed initiation of feeding regimes, under or over prescription, and feed intolerance due to delayed gastric emptying. Further, recent evidence raises doubt as to the benefit of early vs delayed initiation of enteral nutrition and the delivery of calories to full prescribed target early in critical illness. Therefore, an exploration of whether there has been a change in nutrition delivery over time to reflect recommendations, and whether potential barriers to nutrition adequacy are as prevalent now as in the past, is required.
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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
88262
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Mr Luke Weinel
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Address
88262
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Royal Adelaide Hospital, Port Road, South Australia, Adelaide, 5000
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Country
88262
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Australia
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Phone
88262
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+61 439 848 000
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Fax
88262
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Email
88262
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[email protected]
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Contact person for public queries
Name
88263
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Matthew Summers
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Address
88263
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Royal Adelaide Hospital, Port Road, South Australia, Adelaide, 5000
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Country
88263
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Australia
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Phone
88263
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+61 8 707 41765
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Fax
88263
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Email
88263
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[email protected]
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Contact person for scientific queries
Name
88264
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Lee-anne Chapple
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Address
88264
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Royal Adelaide Hospital, Port Road, South Australia, Adelaide, 5000
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Country
88264
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Australia
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Phone
88264
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+61 8 707 41763
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Fax
88264
0
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Email
88264
0
[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
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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
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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