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Stroke AcuteIMPACT-NEURONCT06849011

Inflammatory and Metabolic Prognostic Assessment in Critically Ill Neurological Patients

An observational study of Stroke Acute and Encephalitis, run by Yan Zhang at 19 sites in China.

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Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

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Trial summary

The study aims to develop and validate a prognostic prediction model for adverse outcomes in neurocritical patients receiving enteral nutrition based on key inflammatory and metabolic markers. Read more about this study

Who is it for?
Ages 18 to 80 years
How many people
1,185 participants
Where
19 sitesChina
Study dates
1 Mar 2025to 31 Mar 2027
Phase
Observational

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: The study population consists of critically ill neurocritical patients in the acute phase who are receiving enteral nutrition (EN) treatment in the Neurocritical Care Unit (NICU).

Who may be able to join

  • Age between 18 and 80 years, no gender restrictions.
  • Within 7 days of disease onset and expected NICU stay of at least 7 days.
  • Eligible for enrollment within 24 hours of NICU admission, with enteral nutrition (EN) initiated and continued for at least 7 days.
  • Non-traumatic severe brain injury patients (including cerebrovascular disease and encephalitis) with a Glasgow Coma Scale (GCS) score ≤12.
  • NRS 2002 score ≥3.
  • Kuwata drinking test ≥ grade 3.
  • Acute Gastrointestinal Injury (AGI) grade 1 or 2.
  • Signed informed consent obtained from the patient or their legal representative.

Who cannot join

  • Severe malnutrition prior to admission, defined as BMI < 16 kg/m².
  • Pregnant or lactating women.
  • Receiving hypothermia treatment or core body temperature < 36°C.
  • End-stage disease with an expected survival time of < 48 hours, or severe dysfunction of the heart, lungs, or other vital organs, leading to hemodynamic instability.
  • Malignant tumors.

Trial locations and contacts

19 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Yan Zhang, MD., Ph D. contact

8613671376710

zhangylq@sina.com

Fei Tian, MD., Ph D. contact

8618201303685

smile21tian@163.com

19 sites in 1 country

China19 sites
  • Beijing Hui People's Hospital

    Beijing, Beijing Municipality, 100053

    Yanbo He, 8618612691914, htyopen@163.com

  • Xuanwu Hospital, Capital Medical University

    Beijing, Beijing Municipality, 100053

    Yan Zhang, 8613671376710, zhangylq@sina.com

  • You'anmen Hospital

    Beijing, Beijing Municipality, 100069

    Dan Xin, 8615321688898, 1195048308@qq.com

  • The Ninth Medical Center of Chinese PLA General Hospital

    Beijing, Beijing Municipality, 100700

    Juan Du, 8613901362737, juanzijuanzi@263.net

  • Chifeng Municipal Hospital

    Chifeng, Neimenggu, 024000

    Huijie Zhou, 8613948690409, 1031581493@qq.com

  • Guizhou Provincial People's Hospital

    Guiyang, Guizhou, 550002

    Xiao Hu, 8618096105119, 18096105119@163.com

  • Inner Mongolia Autonomous Region People's Hospital

    Hohhot, Inner Mongolia, 010017

    Runxiu Zhu, 8618047191885, zhurunxiu@163.com

  • The First Hospital of Jilin University

    Jilin City, Jilin, 130021

    Jie Cao, 8613756947788, cjie@jlu.edu.cn

  • Qilu Hospital of Shandong University

    Jinan, Shandong, 250012

    Qinzhou Wang, 8618560085523, qinzhouwang@163.com

  • The 960th Hospital of Joint Logistics Support Force of Chinese PLA

    Jinan, Shandong, 250031

    Huaiqiang Hu, 8613156189722, huhuaiqiang@126.com

  • The First People's Hospital of Yunnan Province

    Kunming, Yunnan, 650032

    Lei Zhang, 8613759176858, 845585258@qq.com

  • The 940th Hospital of Joint Logistics Support Force of Chinese PLA

    Lanzhou, Gansu, 730050

    Xiaoyan Zhang, 8613919931411, zhangxiaoyan060110@163.com

  • Liaocheng People's Hospital

    Liaocheng, Shandong, 252000

    Dong Guo, 8613396258699, guodonglc@126.com

  • The First Hospital of Hebei Medical University

    Shijiazhuang, Heibei, 050031

    Jia Tian, 8615097392050, 15097392050@163.com

  • The Second Affiliated Hospital of Suzhou University

    Suzhou, Jiangsu, 215004

    Jijun Shi, 8615895551663, shijijun2008@126.com

  • The Second Hospital of Shanxi Medical University

    Taiyuan, Shanxi, 030001

    Liansheng Ma, 8615935111597, zly4200@sina.com

  • Tangshan People's Hospital

    Tangshan, Hebei, 063000

    Yan Wang, 8613333299772, doctor_wy@163.com

  • General Hospital of Ningxia Medical University

    Yinchuan, Ningxia, 750004

    Tao Guo, 8613895092758, zfgt1@163.com

  • Affiliated Hospital of Zunyi Medical University

    Zunyi, Guizhou, 563003

    Zucai Xu, 8613368663217, docxzc@126.com

Other trials in China

About this study

Official title: Development and Validation of a Prognostic Prediction Model for Adverse Outcomes in Neurocritical Patients Receiving Enteral Nutrition Based on Key Inflammatory and Metabolic Markers

The study aims to develop and validate a prognostic prediction model for adverse outcomes in neurocritical patients receiving enteral nutrition based on key inflammatory and metabolic markers. This model will serve as a clinical tool to help physicians identify high-risk patients and guide individualized nutritional support strategies.

Read the detailed description

A multi-center, prospective case data collection study will be conducted across 19 tertiary hospitals in China. Based on this, a predictive assessment model for poor prognosis in neurocritically ill patients receiving enteral nutrition support will be developed and validated, using key inflammatory and metabolic markers. During the data collection process, comprehensive clinical information will be extracted, including patient demographic data, clinical indicators, and hematological markers. By conducting in-depth analysis and processing of this vast and detailed clinical and laboratory data, a nomogram for predicting poor prognosis in neurocritical care patients receiving enteral nutrition support will be constructed using statistical methods and data analysis techniques in R. Once the model is built, it will undergo rigorous validation on an independent external dataset to ensure its accuracy and reliability. The goal is to create a precise assessment tool for clinicians, helping them to quickly and accurately identify high-nutritional-risk patients, thereby providing a solid scientific foundation for the formulation of individualized nutrition support strategies, ultimately improving the prognosis of neurocritical patients.

Keywords
enteral nutrition, adverse prognosis, prediction model, non-traumatic severe brain injury
Medical subject headings
Stroke, Encephalitis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT06849011
Study groupRoleWhat they receive
mild Inflammation & Metabolic dysfunctionFirst, a predictive model for poor prognosis is constructed through screening of independent variables after data collection. Then, stratified analysis is conducted with inflammatory markers such as C-reactive protein and interleukin-6, and metabolic markers such as blood glucose and insulin dosage.
Moderate Inflammation & Metabolic DysregulationFirst, a predictive model for poor prognosis is constructed through screening of independent variables after data collection. Then, stratified analysis is conducted with inflammatory markers such as C-reactive protein and interleukin-6, and metabolic markers such as blood glucose and insulin dosage.
High Inflammation & Severe Metabolic DysregulationFirst, a predictive model for poor prognosis is constructed through screening of independent variables after data collection. Then, stratified analysis is conducted with inflammatory markers such as C-reactive protein and interleukin-6, and metabolic markers such as blood glucose and insulin dosage.
Peptide-Based NutritionSelect patients who received peptide-based formulas from the entire database for poor prognosis analysis.
Whole Protein NutritionSelect patients who received whole protein formulas from the database for poor prognosis analysis.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. All-cause mortality at Day 28 of enteral nutrition therapy

    Measured: From enrollment to 28 days after the initiation of enteral nutrition

Secondary outcomes (12)
  1. Nutritional goal achievement rate at Day 3 (caloric and protein intake reaching 70%-100% of calculated target)

    Measured: At Day 3 after the initiation of enteral nutrition

  2. Adverse outcome rate at Day 90 (defined as a Modified Rankin Scale score ≥ 3)

    Measured: At Day 90 after the initiation of enteral nutrition

  3. Incidence of infectious complications within 14 days (including pneumonia, urinary tract infections, bloodstream infections, skin infections, and Clostridium difficile infections)

    Measured: Within 14 days after the initiation of enteral nutrition

  4. Gastrointestinal intolerance within 14 days (gastric residual volume > 200 mL, nausea, vomiting, bloating, diarrhea)

    The gastric residual volume is assessed every 4 hours by the nurse through aspiration via the nasogastric tube. Other clinical manifestations such as nausea, vomiting, bloating, and diarrhea are assessed through daily observation by the attending physician.

    Measured: Within 14 days after the initiation of enteral nutrition

  5. Incidence of gastrointestinal bleeding within 14 days (gastric occult blood, fecal occult blood, hematemesis, melena, hematochezia)

    Measured: Within 14 days after the initiation of enteral nutrition

  6. Number of days with random blood glucose > 10 mmol/L within 14 days

    Measured: Within 14 days after the initiation of enteral nutrition

  7. Average daily insulin requirement within 14 days

    Measured: Within 14 days after the initiation of enteral nutrition

  8. Incidence of hypophosphatemia within 3 days

    Measured: Within 3 days after the initiation of enteral nutrition

  9. Duration of mechanical ventilation within 14 days

    Measured: Within 14 days after the initiation of enteral nutrition

  10. Length of NICU stay

    Measured: From enrollment to discharge from the NICU, up to 1 year.

  11. Total hospital stay duration

    Measured: From enrollment to discharge, up to 1 year.

  12. 90-day readmission rate post-discharge

    Measured: Within 90 days after discharge

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Feb 2025
  2. Study start1 Mar 2025 (estimated)
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Mar 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
1,185 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06849011
Sponsor's protocol ID
xwzc202500102
Acronym
IMPACT-NEURO
Status last verified
Feb 2025
First submitted
12 Feb 2025
Last updated
27 Feb 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: De-identified individual participant data (IPD) will be shared. Available data includes demographic information, clinical characteristics, laboratory results, and outcome measures.

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