Implementation of a clinical decision rule to optimize hospital admission policy of patients with febrile urinary tract infection

Implementation of a clinical decision rule to optimize hospital admission policy of patients with febrile urinary tract infection - Prediction rule for admission policy in complicated UTI Leiden (PRACTICE)

Status

Active, not recruiting

Phases

Unknown

Study type

Interventional

Source

NL-OMON

Registry ID

NL-OMON41359

Enrollment

700

Registered

2011-05-11

Start date

2012-05-07

Completion date

Unknown

Last updated

2024-06-11

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

febrile urinary tract infection pyelonephritis

Interventions

Use of the Prediction Rule for Admission policy in Complicated urinary Tract InfeCtion LEiden (PRACTICE) to help guide physicians. The PRACTICE-score can be divided into several risk classes. Acco

Eligibility

Age

18 Years to 99 Years

Inclusion criteria

Inclusion criteria: 1. Competent patient aged 18 years or above 2. One or more symptom(s) suggestive of urinary tract infection (UTI) (dysuria, frequency or urgency; perineal or suprapubic pain; costovertebral tenderness or flank pain) 3. Fever (ear of rectal temperature of 38.2 oC or higher, or axillary temperature of 38.0 oC or higher), or a history of feeling feverish with shivering or rigors including the past 24 hours 4. Positive urine nitrate test and/or leukocyturia as depicted by positive leukocyte esterase test or microscopy

Exclusion criteria

Exclusion criteria: 1. Known allergy to fluoroquinolones 2. Female patients who are pregnant or lactating 3. Patients known with polycystic kidney disease 4. Patients on permanent renal replacement therapy (hemodialysis or peritoneal dialysis) 5. Patients with history of kidney transplantation 6. Residence outside country of enrolment 7. Inability to speak or read Dutch

Design outcomes

Primary

Measure	Time frame
The primary objective will be evaluated by primary and secondary outcome measures. The primary outcome measure are primary hospital admission rate (i.e. the percentage of patients presenting with FUTI at ED who will directly be admitted to hospital) and secondary hospital admission rate (i.e. the percentage of low-risk patients with PRACTICE	—

Secondary

Measure	Time frame
The secondary outcome will be evaluated from a 3-months perspective. Costs will include the time to assess the decision rule, primary and secondary hospitalization costs, extra costs of primary care and the costs of radiologic diagnostics (as home based management might also lead to reduction in radiologic evaluations to search for underlying urologic abnormalities). Patients* satisfaction with application of the PRACTICE will be evaluated soon after enrolment and 1 month thereafter.	—

Measure

Time frame

The secondary outcome will be evaluated from a 3-months perspective. Costs will include the time to assess the decision rule, primary and secondary hospitalization costs, extra costs of primary care and the costs of radiologic diagnostics (as home based management might also lead to reduction in radiologic evaluations to search for underlying urologic abnormalities). Patients* satisfaction with application of the PRACTICE will be evaluated soon after enrolment and 1 month thereafter.

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Countries

Netherlands

Outcome results

None listed

Source: NL-OMON (via WHO ICTRP)