Critical Illness
Conditions
Keywords
ED, Critical illness, Decision making, POC test, suPAR
Brief summary
Will the use of a clinical decision algorithm in the ED improve discharge or admission decisions.
Detailed description
Background Crowding and readmissions are common challenges in Emergency departments across Europe. The decision whether to admit or discharge the patient is challenging and is often based on clinical signs and symptoms e.g. blood pressure, pulse, respiratory rate, oxygen saturation and temperature. But some patients are unnecessarily admitted and may have been better off if sent home. Other patients may be discharged without - and one out of five patients are readmitted within a month raising the question whether the patient should have been admitted at first presentation in the ED. suPAR is a strong prognostic biomarker measured routinely in acute medical patients in some emergency department (ED) settings.suPAR is a broadly applicable biomarker of risk, and it has been developed an algorithm for simple interpretation of suPAR in clinical decisions for the study. Objective To evaluate the use of a clinical decision algorithm in the ED with the aim of improving discharge or admission decisions.
Interventions
DIAGNOSTIC_TESTsuPAR algoritm
All medical patients attending to the ED and who will have blood drawn for routine examination will be part of the study. In patients with low suPAR (green group, suPAR below 3 ng/ml) and in patients with high suPAR (red group, suPAR \> 6 ng/mL) the Intervention will be carried out
Sponsors
University of Copenhagen
Helsinki University Central Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to 104 Years
Healthy volunteers
Yes
Inclusion criteria
* All patients above 18 years * who are having blood taken for biochemical analysis when attending the ED
Exclusion criteria
* Acute medical patients that do not have blood drawn for routine biochemical testing. * Pregnant * Under 18 years old * Terminally ill patients.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Discharges | 30 days | Number of discharges from the ED within 24 hours |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Admissions | 30 days | Number of admissions to hospital |
| Length of stay | 30 days | Length of stay during admission |
| Readmissions | 1,7 and 30 days | Number of readmissions |
| Mortality | 30 days | Number of Mortality |
Other
| Measure | Time frame | Description |
|---|---|---|
| Economical savings | 30 days | Amount of money |
Countries
Finland
Outcome results
None listed