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ComaPRECOMNCT05321459

Predictive Outcome in Comatose Patients

An observational study of Coma and Heart Arrest, run by Assistance Publique - Hôpitaux de Paris at 7 sites in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Evaluating the prognosis of comatose patients after cardiac arrest (CA) in the intensive care unit (ICU) remains challenging. It requires a multimodal approach combining standardized clinical examination, serum biomarkers, imaging and classically electrophysiological examinations, (among them auditive evoked… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Coma, Heart Arrest, Cardiopulmonary Resuscitation
What is being tested?
Neurological prognosis
How many people
100 participants
Where
7 sitesFrance
Study dates
15 Nov 2023to 29 May 2028
Phase
Observational
Are there results?
Not yet: the study is under way

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 years and older
  • All sexes
  • Adult, Older adult

Study population: Adult patients admitted to intensive care following a cardica arrest.

Who may be able to join

  • Age above18 years old
  • Patient affiliated to a French Heath Care Insurance
  • Admitted in the intensive care unit (ICU) for coma post extra- or intra-hospital cardiac arrest (CA) with shockable or non-shockable rhythm
  • Persistent coma on day 3 after post CA, defined by the inability to respond to a verbal command in an appropriate manner (motor Glasgow components ≤ 3) and at the time of neurophysiological recordings (D3-D7 ± week -end).

Who cannot join

  • Decision to limit resuscitation therapies taken by the resuscitation team
  • Inability to perform the auditory evoked potentials (AEP) (deafness, skin lesion or any condition preventing to record AEP).
  • Opposition by the trusted person or by the patient once he/she wakes up

Trial locations and contacts

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

Nathalie KUBIS, Md, PhD contact

+33(0)149958324

nathalie.kubis@aphp.fr

Romain SONNEVILLE, Md, PhD contact

+33(0)140256139

romain.sonneville@aphp.fr

7 sites in 1 country

France7 sites, 6 recruiting
  • APHP Avicenne Hospital - Réanimation médico-chirurgicale

    Bobigny, 93000

    Johanna OZIEL, Ph, +33 1 48 95 52 41, johanna.oziel@aphp.fr

    Johanna OZIEL, Ph

    Recruiting
  • APHP Lariboisière Hospital, Clinical Physiology Department

    Paris, 75010

    Active, not recruiting
  • APHP Laribosière Hospital - Service de Réanimation Médical et Toxicologique

    Paris, 75010

    Bruno MEGARBANE, MD, PhD, +33 (0)1 49 95 64 91, bruno.megarbane@aphp.fr

    Bruno MEGARBANE, Md, PhD

    Recruiting
  • APHP Cochin Hospital - médecine intensive-réanimation

    Paris, 75014

    Sarah BENGHANEM, Ph, +33 1 58 41 25 33, sarah.benghanem@aphp.fr

    Sarah BENGHANEM, Ph

    Recruiting
  • APHP HEGP hospital - Réanimation médicale

    Paris, 75015

    Jean-Luc DIEHL, Md,PhD, jean-luc.diehl@aphp.fr

    Jean-Luc DIEHL, Md,PhD

    Recruiting
  • APHP Bichat Hospital -Médecine intensive - réanimation infectieuse

    Paris, 75018

    Marc DOMAN, Ph, +33 1 40 25 79 24, marc.doman@aphp.fr

    Marc DOMAN, Ph

    Recruiting
  • Delafontaine Hospital - médecine intensive-réanimation

    Saint-Denis, 93200

    Daniel DA SILVA, Md, daniel.silva@ch-stdenis.mssante.fr

    Daniel DA SILVA, Md

    Recruiting

Other trials in France

About this study

Official title: New Predictive Tool of Awakening in Comatose Patients in the Intensive Care Unit

Evaluating the prognosis of comatose patients after cardiac arrest (CA) in the intensive care unit (ICU) remains challenging. It requires a multimodal approach combining standardized clinical examination, serum biomarkers, imaging and classically electrophysiological examinations, (among them auditive evoked potentials or AEP) but none has a sufficient sensitivity/specificity. In a preliminary study, the investigators developed an algorithm from the signal collected with AEP, and generated a probability map to visually classify the participants after the algorithm processing. Participants could be classified either with a good neurological prognosis or with bad neurological prognosis or death.

The investigators hypothesize that the "PRECOM" tool, applied blindly to a large prospective multicenter cohort of patients admitted to intensive care for coma in the aftermath of CA will predict neurological prognosis at 3 months with high sensitivity and specificity.

Read the detailed description

Evaluating the prognosis of comatose participants after cardiac arrest (CA) in the intensive care unit remains challenging. It requires a multimodal approach combining standardized clinical examination, serum biomarkers, imaging and classically electrophysiological examinations: 1 / the electroencephalogram, bad prognosis assessed when the electroencephalogram (EEG) is discontinuous, areactive, monotone,…), 2 / somesthetic evoked potentials, the absence of the N20 cortical wave has a specificity of poor prognosis of 68-100% and 3 / auditory evoked potentials (AEP), the presence of mismatchnegativity (MMN) would be of good prognosis with a specificity up to 90% but rarely performed in current practice. Routinely, these examinations are sometimes difficult to interpret in sedated participants, in an intensive care unit environment that generates numerous artefacts. Above all, all these techniques require the presence of a neurophysiology unit, with few experts available.

In a preliminary study, in collaboration with the applied mathematics laboratory of the ENS (Ecole Normale Supérieure), an algorithm was developed from the signal extracted from AEP. A probability map was generated with a software allowing to visually classify the participants after processing signal by the algorithm in a cluster of points with a high specificity into "good neurological prognosis" and "bad neurological prognosis". Neither artifacts or sedation prevented data analysis.

The investigators hypothesize that the "PRECOM" tool, applied blindly to a large prospective multicenter cohort of participants admitted to intensive care for coma in the aftermath of a caridiac arrest will predict the neurological prognosis of participants with high sensitivity and specificity. This tool, carried out during the first week of the coma, will be compared to a standardized procedure used routinely by the participating resuscitators.

Being tested
Neurological prognosis
Keywords
Post cardiac arrest for comatose patients, Electroencephalography, Somatosensory evoked potentials, Auditory evoked potentials, Prognosis, Algorithms, Classification
Medical subject headings
Coma, Heart Arrest

What participants receive

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

  • Neurological prognosisOther

    In usual practice, in intensive care unit, evaluating the neurological prognosis of comatose patients after cardiac arrest requires a multimodal approach combining standardized clinical examination, serum biomarkers, imaging and classically electrophysiological examinations (among them auditive evoked potentials or AEP).

    An algorithm (PRECOM tool) which has been previously developed from the signal extracted from AEP allows to visually classify the patients after processing signal by the algorithm in a cluster of points with a high specificity into "good neurological prognosis" and "bad neurological prognosis".

    The AEP signals recorded in the 1st and 2nd week of patient inclusion are to be collected by the neurophysiologist. At the end of the patient's participation in the study, these data will be encrypted, anonymized and transmitted to the mathematician to be processed by the PRECOM tool.

Study groups in NCT05321459
Study groupRoleWhat they receive
Comatose patients in intensive care unitPatient admitted in the intensive care unit (ICU) for post cardiac arrest (CA) coma, persistent for at least 3 days after CA.
Receives: Other: Neurological prognosis

What is being measured

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

  1. Awakening within 3 months

    Awakening is defined as normal motor activity in response to the 3 instructions for the motor component M of the FOUR score (show your thumb, make the V for victory and show your fist; M = 4). This criterion will be collected by the doctor in charge of the patient at the time of the assessment and will be dated.

    Measured: within 3 months ± 2 weeks after inclusion

Secondary outcomes (17)
  1. CPC score within 3 months

    CPC (Cerebral Performance Category) score is performed wether patient is still hospitalized or returned home. It is performed by phone call if patient returned home.

    Range of values rates neurological status after cardiac arrest on a scale of 1 to 5 (1 for good cerebral performance up to 5 for brain death).

    Measured: 3 months ± 2 weeks after inclusion

  2. mRS score within 3 months

    mRS (Modified Rankin Scale) scores is performed wether patient is still hospitalized or returned home. It is performed by phone call if patient returned home.

    mRS (modified Rankin Scale) scale measures degree of disability/dependence in the daily activities of people who have suffered a stroke or other causes of neurological disability. Score can be between 0 (no symptoms at all) and 5 (major disability : bedridden, incontinent and requiring constant nursing care and attention).

    Measured: 3 months ± 2 weeks after inclusion

  3. FOUR score within 3 months

    FOUR (Full Outline of UnResponsiveness) score is performed only if patient is still hospitalized (being awake or not).

    FOUR score is a grading scale for assessing the level of consciousness performed on patients with severe neurologic impairment..It addresses four domains of neurological functioning: Eye response; Motor response ; Brainstem score and Respiratory score.

    Score is ranging from 0 to 16 where the lower the score, the greater the coma gravity.

    Measured: 3 months ± 2 weeks after inclusion

  4. GOSE score within 3 months

    GOSE (Extended Glasgow Outcome Scale) score is performed wether patient is still hospitalized or returned home.

    GOSE score classifies global outcomes in traumatic brain injury survivors. It rates patient status into one of eight categories ranging from 8 (Upper good recovery) to 1 (Dead).

    Measured: 3 months ± 2 weeks after inclusion

  5. CPC score within 6 months

    CPC (Cerebral Performance Category) score is performed wether patient is still hospitalized or returned home. It is performed by phone call if patient returned home.

    Range of values rates neurological status after cardiac arrest on a scale of 1 to 5 (1 for good cerebral performance up to 5 for brain death).

    Measured: 6 months ± 2 weeks after inclusion

  6. mRS score within 6 months

    mRS (Modified Rankin Scale) scores is performed wether patient is still hospitalized or returned home. It is performed by phone call if patient returned home.

    mRS (modified Rankin Scale) scale measures degree of disability/dependence in the daily activities of people who have suffered a stroke or other causes of neurological disability. Score can be between 0 (no symptoms at all) and 5 (major disability : bedridden, incontinent and requiring constant nursing care and attention).

    Measured: within 6 months ± 2 weeks after inclusion

  7. GOSE score within 6 months

    GOSE (Extended Glasgow Outcome Scale) score is performed wether patient is still hospitalized or returned home.

    GOSE score classifies global outcomes in traumatic brain injury survivors. It rates patient status into one of eight categories ranging from 8 (Upper good recovery) to 1 (Dead).

    Measured: within 6 months ± 2 weeks after inclusion

  8. Awakening within 6 months ± 2 weeks

    Awakening is defined as normal motor activity in response to the 3 instructions for the motor component M of the FOUR score (show your thumb, make the V for victory and show your fist; M = 4). This criterion will be collected by the doctor in charge of the patient at the time of the assessment and will be dated. The measurement takes place only if patient is still hospitalized.

    Measured: within 6 months ± 2 weeks after inclusion

  9. CRS-R score within 6 months

    CRS-R (Coma Recovery Scale - Revised) is a standardized neurobehavioral assessment measure designed for use in patients with disorders of consciousness. The scale is intented to be used to establish diagnosis, monitor behavioral recovery and predict outcome. It is performed only if patient is still hospitalized.

    The total score ranges between 0 (worst) and 23 (best).

    Measured: within 6 months ± 2 weeks after inclusion

  10. PRECOM tool - first week of coma

    Comparison of the ability of the PRECOM tool using clinical and electrophysiological data at inclusion (the first week of coma), to classify patients with good prognosis, poor prognosis and indeterminate prognosis with respect to this same categorization using the usual evaluation criteria performed routinely by participating resuscitations (clinical examination and EEG for all and evoked potentials in addition for some).

    Measured: Inclusion visit (3 to 7 days after cardiac arrest +/- 2 days if week-end)

  11. PRECOM tool - second week of coma

    Comparison of the ability of the PRECOM tool using clinical and electrophysiological data the second week of coma, to classify patients with good prognosis, poor prognosis and indeterminate prognosis with respect to this same categorization using the usual evaluation criteria performed routinely by participating resuscitations (clinical examination and EEG for all and evoked potentials in addition for some).

    Measured: One week visit (one week after inclusion visit +/- 2 days)

  12. PRECOM tool - first and second week of coma

    Comparison of the ability of the PRECOM tool using combinaison of clinical and electrophysiological data collected both at inclusion and one week later (the first two weeks of coma), to classify patients with good prognosis, poor prognosis and indeterminate prognosis with respect to this same categorization using the usual evaluation criteria performed routinely by participating resuscitations (clinical examination and EEG for all and evoked potentials in addition for some).

    Measured: Inclusion and one week visits

  13. Awakening - second week of coma

    Awakening is defined as normal motor activity in response to the 3 instructions for the motor component M of the FOUR score (show your thumb, make the V for victory and show your fist; M = 4). This criterion will be collected by the doctor in charge of the patient at the time of the assessment and will be dated.

    Measured: One week visit (one week after inclusion visit +/- 2 days)

  14. NSE blood marker

    Comparison of the ability to predict awakening with the PRECOM tool using the NSE blood marker (neuron- spécific enolase) collected 3 days after cardiac arrest between the patients awakened from the coma and those who are not.

    Measured: 3 days post cardiac arrest

  15. Glial blood markor

    Comparison of the ability to predict awakening with the PRECOM tool using the Glial Fibrillary Acidic Protein (GFAP) collected at the inclusion visit between the patients awakened from the coma and those who are not.

    Measured: Inclusion visit (3 to 7 days after cardiac arrest +/- 2 days if week-end)

  16. Neuronal blood markor

    Comparison of the ability to predict awakening with the PRECOM tool using the Neurofilament blood marker collected at the inclusion visit between the patients awakened from the coma and those who are not.

    Measured: Inclusion visit (3 to 7 days after cardiac arrest +/- 2 days if week-end)

  17. Inflammatory blood markor

    Comparison of the ability to predict awakening with the PRECOM tool using the inflammatory blood markers : Kynurenine and Tryptophan; collected at the inclusion visit between the patients awakened from the coma and those who are not.

    Measured: Inclusion visit (3 to 7 days after cardiac arrest +/- 2 days if week-end)

Timeline

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

  1. First posted11 Apr 2022
  2. Study start15 Nov 2023
  3. Primary completion1 Mar 2028 (estimated)
  4. Study completion29 May 2028 (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
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05321459
Sponsor's protocol ID
AOR 20045
Acronym
PRECOM
Status last verified
Dec 2025
First submitted
14 Mar 2022
Last updated
23 Dec 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Coma and Heart Arrest, run by Assistance Publique - Hôpitaux de Paris at 7 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 23 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Nathalie KUBIS, Md, PhD (+33(0)149958324, nathalie.kubis@aphp.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Awakening within 3 months (time frame: within 3 months ± 2 weeks after inclusion). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Dec 2025.

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