Oncology
Conditions
Keywords
cancer care, emergency care, prediction model, admission
Brief summary
The goal of this single center prospective observational study is to determine the agreement between the cancer admission score (CAS) predicted disposition and the actual disposition in patients with an active cancer diagnosis visiting the emergency department (ED). The main question it aims to answer are: Is the performance of the CAS good enough to play a potential role in the ED care process. For each participant the CAS will be calculated and compared to the actual outcome.
Detailed description
The goal of this single center prospective observational study is to determine the agreement between the cancer admission score (CAS) predicted disposition and the actual disposition in patients with an active cancer diagnosis visiting the emergency department (ED). The main question it aims to answer are: Is the performance of the CAS good enough to play a potential role in the ED care process. The first part of this study is an observational part. For patients with cancer that are presented to the emergency department (ED) the cancer admission score (CAS) will be calculated by the model both after triage and after the first blood results are in. Furthermore, the expected disposition will be asked to the attending nurse after triage and after the first blood results. Finally, the actual disposition will be written down after the patient has left the ED, in combination with ED length of stay (LOS) and the time for the attending physician to reach a decision about the disposition (time-to-disposition) and the time for a patient to leave the ED (time-to-leave). The second part is the interventional part. In this part we introduce an early bed reservation intervention. The CAS is still calculated for the patient. If the CAS is 80% or higher based on the triage, the attending physician will be alerted and a call to the bed coordinator will be placed to reserve a bed in advance. After the first blood results are known the second CAS will be calculated, if this drops below 70% the reserved bed can be canceled by the attending physician. Similar to the first part, the expected disposition from the attending nurse after triage and after first blood results will be collected. Finally, the actual disposition, ED LOS, time-to-disposition and time-to-leave will be noted.
Interventions
OTHERCancer Admission Score Prediction Model
A prediction model that calculates the chance for a patient to be admitted after triage and after first blood results
Sponsors
Erasmus Medical Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with solid or hematological malignancies and receiving systemic therapy or having received systemic therapy within the last 3 months. * Presented at or admitted from the emergency department for the oncology, hematology neuro- or lung-oncology clinical unit.
Exclusion criteria
* \<18 years old * Only received a surgical intervention as cancer treatment * Admitted to the ED for the surgical department
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cancer Admission Score | Through study completion, an average of 6 months | Cancer Admission Score (CAS) calculated after triage and after first blood results, ranging from 0 to 100%. The higher the score the greater the change of admission |
| Agreement between the CAS and the actual disposition | Through study completion, an average of 6 months | Agreement between the CAS predicted outcome and the actual outcome |
| Disposition | Through study completion, an average of 6 months | The outcome of a visit to the ED, being either admission or home |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Agreement between expected disposition by nurse and actual disposition | Through study completion, an average of 6 months | Agreement between the nurse predicted outcome and the actual outcome |
| time-to-disposition | Through study completion, an average of 6 months | The average time between patient's arrival at the emergency department (ED) and the decision to disposition |
| time-to-leave | Through study completion, an average of 6 months | The average time between the decision to disposition and departure from the ED (either home or ward) |
| ED Length of Stay | Through study completion, an average of 6 months | The total time spent in the ED by a patient during their visit |
Other
| Measure | Time frame | Description |
|---|---|---|
| Sex | Through study completion, an average of 6 months | The sex of a patient |
| Type of Treatment | Through study completion, an average of 6 months | Type of cancer treatment a patient receives |
| Type of Cancer | Through study completion, an average of 6 months | The type of cancer a patient has |
| Age | Through study completion, an average of 6 months | The age of a patient |
| Main Complaint | Through study completion, an average of 6 months | Main complaint of ED visit |
| Physical parameters recorded during triage | Through study completion, an average of 6 months | Physical parameters that are recorded during triage and are used in the prediction model |
| First Blood results | Through study completion, an average of 6 months | The blood results that are recorded during triage and are used in the prediction model |
Countries
Netherlands
Contacts
Primary ContactJason den Duijn
Outcome results
None listed