Emergency Department, Non-specific Complaints
Conditions
Keywords
D-dimer, Fast track, emergency
Brief summary
Emergency departments (ED) internationally are treating an increasing number of patients. Most require hospital services but some could be better cared for on alternative pathways. D-dimer has some unique properties. It is non-specific and is elevated in many acute condi- tions; but conversely remains normal in the absence of significant disease. Previous studies have shown that having a normal D-dimer on arrival to the emergency department is associated with a very low risk of 30-day all-cause mortality. The investigators propose a multicenter randomized controlled trial using D-dimer to identify patients at low risk and test if providing this information will change time to discharge disposition by the treating physician.
Interventions
DIAGNOSTIC_TESTD-dimer
The investigators will measure a D-dimer test on participants and randomize on informing the physician on the value.
Sponsors
Slagelse Sygehus
Holbaek Sygehus
Esbjerg Hospital - University Hospital of Southern Denmark
Odense University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 or above * Able to provide oral and written informed consent in Danish * Blood tests ordered on arrival as part of standard of care * Ambulatory on arrival or walking to the ambulance (i.e., stable independent gait) * Normal vital signs (i.e., National Early Warning Score < 3)
Exclusion criteria
* Unstable condition requiring immediate care in the resuscitation area * Triage level red (i.e., the most urgent patients) * Trauma (minor and major) patients * High likelihood of requiring a D-dimer analysis on clinical indications during the current hospital contact (e.g., suspected venous thromboembolic disease) that will be ordered on arrival regardless of this study * Previous participation in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Length of stay | From arrival to physician decision within 4 hours of arrival | Length of initial emergency department stay (i.e., time from arrival to the emergency department to decision to discharge home or transfer to another department is made (as reported from the treating physician to the study nurse)). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 7- and 30-day all-cause mortality from arrival | From arrival until 30-days later | 7- and 30-day all-cause mortality from arrival |
| Hospital length of stay | From arrival until final discharge within 1 month | Hospital length of stay |
| Re-contacts to the emergency department within 30 days from arrival for any reason | From arrival until 30-days later | Re-contacts to the emergency department within 30 days from arrival for any reason |
Countries
Denmark
Contacts
Primary ContactMette Løkke, RN
Backup ContactMikkel Brabrand, MD PhD
Outcome results
None listed