Critical Illness, Emergency Department Patient, Respiratory Failure, Resuscitation, Shock, Trauma (Including Fractures)
Conditions
Keywords
Emergency Department, Resuscitation Room, Critical Care Admission
Brief summary
This prospective multicenter observational study aims to describe resuscitation room activity in France and to compare critical care admission within 24 hours between patients directly admitted to the resuscitation room and those admitted secondarily after initial emergency department management. Adult patients admitted to the resuscitation room over a 72-hour period in participating centers will be included. Data collection includes patient characteristics, triage severity, physiological parameters, critical interventions, and outcomes at 24 hours.
Detailed description
This is a prospective, multicenter, observational cohort study including all consecutive adult patients admitted to the resuscitation room in participating emergency departments over a predefined 72-hour study period. Patients are categorized according to their mode of admission to the resuscitation room (direct or secondary after initial emergency department management). No intervention is assigned by the study, and patient care follows usual practice and local protocols. Data collection includes patient-level clinical and physiological variables, resuscitation room processes of care, organizational characteristics at the center level, and practitioner-level characteristics. The primary outcome is critical care admission or death within 24 hours after resuscitation room admission. Statistical analysis Analyses will be conducted in adult patients (≥18 years) admitted to the resuscitation room. Patients will be categorized according to the mode of resuscitation room admission (direct vs secondary). The primary outcome is critical care admission or death within 24 hours after resuscitation room admission. The primary analysis will compare the proportion of patients meeting the primary outcome between groups using logistic regression, with adjustment for prespecified baseline variables and center effects. Results will be reported as odds ratios with 95% confidence intervals. Secondary and prespecified outcomes will be analyzed descriptively. Missing data will be described and analyses performed on available data. An ancillary analysis will be conducted among patients who receive blood transfusion during resuscitation room management. This ancillary study will use the same prospective observational dataset and will not involve any additional data collection or modification of patient management. Analyses will focus on patient characteristics, indications for transfusion, transfusion practices, and short-term outcomes.
Interventions
OTHEREmergency resuscitation room management (observational)
Patients receive standard emergency care in the resuscitation room according to local protocols and clinician judgment. No intervention is assigned by the study. Clinical management, diagnostic procedures, and therapeutic interventions are recorded for observational purposes only.
Sponsors
Centre Hospitalier Universitaire de Nīmes
Societe Française de Medecine d'urgence
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients (≥18 years old) admitted to the resuscitation room during the study period.
Exclusion criteria
* Patients younger than 18 years.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Critical care admission within 24 hours after resuscitation room admission | Within 24 hours after resuscitation room admission | Proportion of patients admitted to critical care (intensive care unit or intermediate care unit) or deceased within 24 hours following admission to the resuscitation room, comparing direct versus secondary resuscitation room admission. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| All-cause mortality within 24 hours | Within 24 hours after resuscitation room admission | All-cause mortality occurring within 24 hours after resuscitation room admission. |
| Use of critical care interventions in the resuscitation room | Day 1 | Proportion of patients receiving at least one critical care intervention in the resuscitation room, including airway management, mechanical ventilation or non-invasive ventilation, vasopressor therapy, transfusion, renal replacement therapy, or cardiopulmonary resuscitation. |
| Center-level organizational characteristics | Baseline (during study period) | Description of resuscitation room organizational characteristics, including material resources, human resources, and availability of critical care equipment. |
| Physiological severity at resuscitation room admission-part 1 | Baseline | Blood pressure at admission |
| Physiological severity at resuscitation room admission-part 2 | Baseline | Heart rate at admission |
| Physiological severity at resuscitation room admission-part 3 | Baseline | Respiratory rate at admission |
| Physiological severity at resuscitation room admission-part 4 | Baseline | Pulsed oxygen saturation at admission |
| Physiological severity at resuscitation room admission-part 5 | Baseline | Temperature at admission |
| Physiological severity at resuscitation room admission-part 6 | Baseline | Glasgow Coma Scale at admission |
| Physiological severity at resuscitation room admission-part 7 | Baseline | Capillary blood glucose at admission |
| Physiological severity at resuscitation room admission-part 8 | Baseline | Capillary blood glucose at admission |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORRomain Genre Grandpierre, MD
Nîmes University Hospital
Outcome results
None listed