Connected Health, Digestive Emergency, New Pathway
Conditions
Keywords
digestive emergency, new pathway, connected health
Brief summary
The number of emergencies's visits (22 million visits in 2019 in France), the organization of emergencies and the sustainability of the current health system are threatened. In the CHUAP adult emergency department, 60,000 visits were recorded in 2022. Unlike medical emergencies which have structured their care and research activities (heart, brain), and whose organization has demonstrated its general interest for society, digestive surgical emergencies, which involve complex patients (elderly people, comorbidities) , emergency situations and surgical procedures, have never been thought of globally in terms of personalized care and research pathways. Currently, patients treated in emergency are managed without a pre-established optimization program and without a dedicated pathway, where emergency constitutes a major risk factor for postoperative complications. RAUCAMIENS evaluates a new care pathway implemented within the framework of the RHU RAUC : the implementation of the Enhanced rehabilitation after surgery (ERAS) and e-health devices for home monitoring, for patients treated in the emergency room for a digestive pathology. The purpose is to evaluate the effectiveness of the RAUC pathway in reducing the rate of unplanned hospitalization readmission after emergency digestive surgery 30 days postoperative.
Interventions
OTHERERAS
ERAS
OTHERROFIM
teleexpertise solution connecting extra-hospital and intra-hospital practitioners
OTHERDEEPSEN
virtual reality headset to reduce anxiety
OTHERRDS
patch to continuously monitor patients' physiological parameters at home
OTHERGet ready
digital solution for managing patients at home
OTHERLumiradx
taking CRP at home
OTHERDigital Surgery
recording of the different operating times
Sponsors
University Hospital, Rouen
Centre Hospitalier Universitaire, Amiens
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Criterion linked to the protocol : \-- Patient consulted in emergency for a digestive pathology requiring surgery * Search criteria: * Adult patient (≥ 18 years old), * Able to give consent, * Affiliation to a social security scheme
Exclusion criteria
* Criterion linked to the protocol: * Patient leaving hospitalization to a convalescent center * Patient requiring direct operating room (vital emergency or surgical revision) * Patient presenting to the emergency room for a postoperative complication * Patient directly admitted to intensive care * Search criteria: * Pregnant or breastfeeding woman * Patient under guardianship, curatorship or deprived of liberty
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Occurrence of an unscheduled hospitalization readmission | 30 days | Occurrence of an unscheduled hospitalization readmission following digestive surgery performed urgently within 30 days |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of hospitalization linked to the first admission to perform emergency digestive surgery | 30 days | Duration of hospitalization linked to the first admission to perform emergency digestive surgery |
| Quality of life score | 0 day | Quality of life assessed by the scores of the different dimensions of the EQ-5D-5L which is a PROMS, at admission |
| Quality of Life score | 30 days | Quality of life assessed by the scores of the different dimensions of the EQ-5D-5L which is a PROMS |
| Clavien-Dindo score | 30 days | — |
| Transition to emergency without hospitalization | 30 days | Transition to emergency without hospitalization |
| incremental cost-utility ratio | 30 days | incremental cost-utility ratio |
| incremental cost-effectiveness ratio | 30 days | incremental cost-effectiveness ratio (cost per readmission avoided) |
| STAI-Y scale | 0 day | Anxiety assessed by the STAI-Y scale |
Countries
France
Contacts
Primary ContactJean Marc Regimbeau, Pr
Outcome results
None listed