Infected Elders in the Emergency Department: Outcomes and Processes of Care

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT00591955

Enrollment

213

Registered

2008-01-11

Start date

2006-01-31

Completion date

2009-09-30

Last updated

2013-07-12

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Sepsis

Keywords

geriatric, sepsis, outcome assessment(healthcare)

Brief summary

The purpose of this study is to determine factors which predict a complicated hospital course and then to develop from these findings an Emergency Department guideline to assist in knowing who is at highest risk of elderly patients with infection presenting for care.

Detailed description

The study is looking at how closely physicians adhere to treatment guidelines in caring for elderly patients, and then to determine if there are differences in elderly patient disease symptoms that result in a failure to use guidelines. If this is known, physicians can then be aware of these differences and provide appropriate care.

Interventions

None listed

Study design

Observational model

CASE_ONLY

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

65 Years to No maximum

Healthy volunteers

Inclusion criteria

* age 65 or older * blood cultures ordered in the Emergency Department * admitted to the hospital from the Emergency Department

Exclusion criteria

* age less than 65 * prisoners * Patient unable to provide consent and no legally authorized representative available * non-English speaking * ED visit or admission in the last 7 days for the same condition * primary evaluation by the trauma team

Design outcomes

Primary

Measure	Time frame	Description
Complicated Clinical course	0-30 days from ED visit	The presense of any one of the following will constitute a complicated clinical course: 1. mortality at 30 days 2. requirement for ICU admission or ICU-level care withing first 48 hours 3. positive blood cultures

Secondary

Measure	Time frame	Description
Inadequate process of care	entire length of Emergency Department visit and hospitalization	failure to meet any one of the following will be considered inadequate processes of care: 1. obtain blood cultures prior to antibiotic administration 2. administration of antibiotics within 4 hours of presentation 3. measure serum lactate if patient has severe sepsis in the ED 4. Fluid resuscitation of 20-40cc/kg if mean arterial perssure is \<65mmHg despite fluid resuscitation

Countries

United States

Outcome results