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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00155987
Registration number
NCT00155987
Ethics application status
Date submitted
7/09/2005
Date registered
12/09/2005
Date last updated
10/09/2020
Titles & IDs
Public title
The DECRA Trial: Early Decompressive Craniectomy in Patients With Severe Traumatic Brain Injury
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Scientific title
Multi-centre Prospective Randomised Trial of Early Decompressive Craniectomy in Patients With Severe Traumatic Brain Injury
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Secondary ID [1]
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68/02
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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:
Brain Injuries
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Condition category
Condition code
Injuries and Accidents
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Other injuries and accidents
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Neurological
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Other neurological disorders
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Skin
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Other skin conditions
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Surgery - Early decompressive craniectomy
Treatment: Surgery: Early decompressive craniectomy
Large bifrontotemporal decompressive craniectomy
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Intervention code [1]
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Treatment: Surgery
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Proportion (%) of favourable outcomes (GOSE 5-8)
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Assessment method [1]
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Timepoint [1]
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6 month post injury
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Secondary outcome [1]
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Mean and maximum hourly intracranial pressure (ICP)
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Assessment method [1]
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Timepoint [1]
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36hrs post randomisation
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Secondary outcome [2]
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Favourable outcomes (GOSE)
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Assessment method [2]
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Timepoint [2]
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12 months post injury
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Secondary outcome [3]
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Mean GOSE using ordinal logistic regression
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Assessment method [3]
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Timepoint [3]
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6 months and 12 months
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Secondary outcome [4]
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Mortality
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Assessment method [4]
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Timepoint [4]
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hospital, 6 months, 12 months
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Secondary outcome [5]
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length of stay
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Assessment method [5]
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Timepoint [5]
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ICU admisssion
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Secondary outcome [6]
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Brain metabolites using microdialysis (The Alfred Hospital only)
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Assessment method [6]
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Timepoint [6]
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During monitoring phase
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Eligibility
Key inclusion criteria
* Age 15 - 60 years and within the first 72 hrs from time of injury
* Severe diffuse Traumatic Brain Injury defined as:
* GCS < 9 and CT scan* with any evidence of brain swelling CT brain scan (DII + some evidence of swelling or DIII or DIV) OR
* GCS >8 before intubation and DIII or DIV CT brain scan (basal cistern compression ± midline shift)
* ICP monitor in situ. EVD recommended.
* "Refractory ICP" despite best conventional management. Refractory ICP in this study will be defined as the spontaneous persistent increase in ICP despite optimal conventional ICU therapies (including intermittent EVD venting) of >20mm Hg for more than 15 mins (continuously or cumulative over one hour).
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Minimum age
15
Years
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Maximum age
60
Years
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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
Exclusion criteria:
* Intracranial haemorrhage > 3 cm diameter
* Intracranial mixed haemorrhagic contusion >5cm in long axis
* Previous craniectomy
* EDH/SDH/ or large contusion requiring evacuation
* EDH/SDH >0.5 cm thickness
* Spinal cord injury
* Penetrating brain injury
* Arrest at scene
* Unreactive pupils >4mm, and GCS=3
* Neurosurgery contraindicated (eg: severe coagulopathy)
* No chance of survival after consideration of CT and clinical findings following Neurosurgical consultant assessment (eg hemispheric infarct after carotid dissection).
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/08/2003
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/12/2010
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Sample size
Target
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Accrual to date
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Final
155
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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The Alfred Hospital - Melbourne
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Recruitment postcode(s) [1]
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3004 - Melbourne
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Funding & Sponsors
Primary sponsor type
Other
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Name
National Trauma Research Institute
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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National Health and Medical Research Council, Australia
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Address [1]
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Country [1]
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Other collaborator category [2]
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Other
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Name [2]
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Victorian Trauma Foundation
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Address [2]
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Country [2]
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Other collaborator category [3]
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Other
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Name [3]
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ANZICS Foundation
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Address [3]
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Country [3]
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Other collaborator category [4]
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Other
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Name [4]
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Western Australian Institute for Medical Research
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Address [4]
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Country [4]
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Ethics approval
Ethics application status
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Summary
Brief summary
This is a multi-centre randomised trial to evaluate the effect of early decompressive craniectomy on neurological function in patients with severe traumatic brain injury. The primary outcome is neurological function measured at 6 months post injury using the Glasgow Outcome Score. Neurological function is qualified as proportion of favourable outcomes (Glasgow Outcome Score Extended \[GOSE\] grades 5-8).
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Trial website
https://clinicaltrials.gov/study/NCT00155987
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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D. J. Cooper
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Address
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The Alfred Hospital & National Trauma Research Institute
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT00155987
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