| Title: |
ENIGMA-shock: protocol for a study framEwork for aN InteGrated assessMent of cArdiac rehabilitation programmes in patients acutely managed for cardiogenic shock |
| Authors: |
Morici, Nuccia; Foglia, Emanuela; Ferrario, Lucreazia; Pedersini, Paolo; Corda, Marco; Ravera, Amelia; Oreni, Letizia M; Cusmano, Ignazio; Garatti, Laura; Toccafondi, Anastasia; Sacco, Alice; Oliva, Fabrizio; Garascia, Andrea; Frea, Simone; Pistono, Massimo; Aschieri, Daniela; Tavazzi, Guido; Pappalardo, Federico |
| Contributors: |
National Ministry of Health through the Piano Nazionale di Ripresa e Resilienza |
| Source: |
BMJ Open ; volume 15, issue 2, page e092790 ; ISSN 2044-6055 2044-6055 |
| Publisher Information: |
BMJ |
| Publication Year: |
2025 |
| Description: |
Introduction The treatment of patients with cardiogenic shock (CS) has been focused historically on single interventions (medical treatments, percutaneous and surgical interventions and, more recently, various temporary mechanical circulatory supports). However, none of these interventions has significantly changed the short-term prognosis of CS. Moreover, considerable interest in interventions applied in the acute setting has not been matched with comprehensive assessment of patients’ long-term follow-up, not only for survival and rehospitalisation but also for quality of life and functional status, recovery from critical illness and its destructive sequelae, and a global evaluation of the overall sustainability of pathways of care. To fill this knowledge gap, the ENIGMA study will be conducted. Methods and analysis This is a prospective and retrospective multicentre registry conducted under the scientific coordination of the IRCCS Fondazione Don Gnocchi and funded by the Italian Ministry of Health (PNRR-MCNT2-2023-12377767). Data referring to 2000 patients included in the Altshock registry, the largest multicentre CS registry in Italy, will be analysed. A standardised protocol of high-intensity cardiac rehabilitation has been defined and will be followed by the involved institutions after the inclusion of the first 1000 patients. Where feasible, this new pathway will be implemented in every institution. All the patients enrolled will be evaluated according to the Long-Term Conditions Questionnaire, the Kansas City Cardiomyopathy Questionnaire and a questionnaire on the patient experience at 6-month follow-up, to evaluate real-life comparative effects on patient outcomes and experiences. In conclusion, a health technology assessment (HTA) analysis, grounded in the EUnetHTA Core Model, will be conducted to define the potential multidimensional benefits and effects with regard to the overall economic, organisational and social sustainability of the innovative dedicated pathway. Various data sources will be used ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1136/bmjopen-2024-092790 |
| Availability: |
https://doi.org/10.1136/bmjopen-2024-092790; https://syndication.highwire.org/content/doi/10.1136/bmjopen-2024-092790 |
| Rights: |
http://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: |
edsbas.1A642302 |
| Database: |
BASE |