Optimizing Triage and Hospitalisation In Adult General Medical Emergency Patients: the TRIAGE Study

NCT01768494 | Completed

• 1 other identifier: TRIAGE-1
• Study Type: observational
• Target: 7,000
• Locations: 1 country
• Sites: 1

Brief Summary

Patients presenting to the emergency department (ED) currently face inacceptable delays in initial treatment, and long and costly hospital stays due to suboptimal initial triage. Accurate ED triage should focus not only on initial treatment priority, but also on prediction of medical risk and nursing needs to improve site of care decision and to simplify early discharge management. Herein, we propose a large prospective cohort study to optimize initial patient triage for (a) better determination of initial treatment priority, (b) overall risk and need for inhospital treatment and (c) early assessment of post-acute nursing needs.

Conditions

Emergencies

Outcome Measures

Primary Outcomes (3)

• Initial triage priority

  Initial triage priority adjudicated by the attending ED physician. Attending ED physicians will classify all patients at ED discharge as either high triage priority or low triage priority in respect to the time patients need to be seen by a physician based on all available information at ED discharge

  within 30 days

• Adverse 30 day outcome (death or intensive care unit admission) within 30 days following ED admission

  Adverse 30 day outcome (death or intensive care unit admission) within the hospital stay and within 30 days following ED admission

  Within 30 days of ED admission

• Care needs after hospital discharge

  Care needs after hospital discharge will be defined as transfer of patients to a post-acute care institution (i.e. transition to a nursing home and others).

  Within 30 days

Secondary Outcomes (4)

• Time to first physician contact

  Within 30 days

• Time to initiation of adequate medical therapy

  Wihtin 30 days

• Satisfaction with care

  Within 30 days

• Hospital costs

  Within 30 days

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All consecutive medical patients seeking ED care will be included. There will be no exclusions except for non-adult and non-medical patients. We expect to include 5000 - 8000 patients over one year of recruitment.

You may qualify if:

• All consecutive medical patients seeking ED care

You may not qualify if:

• age below 18 years

Sponsors & Collaborators

• University Hospital, Basel, Switzerland: lead

Study Sites (1)

University Clinic, Kantonsspital Aarau

Aarau, Canton of Aargau, 5000, Switzerland

Location

Related Publications (9)

• Haag E, Gregoriano C, Molitor A, Kloter M, Kutz A, Mueller B, Schuetz P. Does mid-regional pro-adrenomedullin (MR-proADM) improve the sequential organ failure assessment-score (SOFA score) for mortality-prediction in patients with acute infections? Results of a prospective observational study. Clin Chem Lab Med. 2021 Jan 14;59(6):1165-1176. doi: 10.1515/cclm-2020-1566. Print 2021 May 26.

  PMID: 33554514 DERIVED

• Eckart A, Hauser SI, Kutz A, Haubitz S, Hausfater P, Amin D, Amin A, Huber A, Mueller B, Schuetz P. Combination of the National Early Warning Score (NEWS) and inflammatory biomarkers for early risk stratification in emergency department patients: results of a multinational, observational study. BMJ Open. 2019 Jan 17;9(1):e024636. doi: 10.1136/bmjopen-2018-024636.

  PMID: 30782737 DERIVED

• Eckart A, Hauser SI, Haubitz S, Struja T, Kutz A, Koch D, Neeser O, Meier MA, Mueller B, Schuetz P. Validation of the hospital frailty risk score in a tertiary care hospital in Switzerland: results of a prospective, observational study. BMJ Open. 2019 Jan 15;9(1):e026923. doi: 10.1136/bmjopen-2018-026923.

  PMID: 30647051 DERIVED

• Kutz A, Struja T, Hausfater P, Amin D, Amin A, Haubitz S, Bernard M, Huber A, Mueller B, Schuetz P; TRIAGE study group. The association of admission hyperglycaemia and adverse clinical outcome in medical emergencies: the multinational, prospective, observational TRIAGE study. Diabet Med. 2017 Jul;34(7):973-982. doi: 10.1111/dme.13325. Epub 2017 Feb 28.

  PMID: 28164367 DERIVED

• Faessler L, Kutz A, Haubitz S, Mueller B, Perrig-Chiello P, Schuetz P. Psychological distress in medical patients 30 days following an emergency department admission: results from a prospective, observational study. BMC Emerg Med. 2016 Aug 24;16(1):33. doi: 10.1186/s12873-016-0097-y.

  PMID: 27557531 DERIVED

• Laukemann S, Kasper N, Kulkarni P, Steiner D, Rast AC, Kutz A, Felder S, Haubitz S, Faessler L, Huber A, Fux CA, Mueller B, Schuetz P. Can We Reduce Negative Blood Cultures With Clinical Scores and Blood Markers? Results From an Observational Cohort Study. Medicine (Baltimore). 2015 Dec;94(49):e2264. doi: 10.1097/MD.0000000000002264.

  PMID: 26656373 DERIVED

• Schuetz P, Hausfater P, Amin D, Amin A, Haubitz S, Faessler L, Kutz A, Conca A, Reutlinger B, Canavaggio P, Sauvin G, Bernard M, Huber A, Mueller B; TRIAGE Study group. Biomarkers from distinct biological pathways improve early risk stratification in medical emergency patients: the multinational, prospective, observational TRIAGE study. Crit Care. 2015 Oct 29;19:377. doi: 10.1186/s13054-015-1098-z.

  PMID: 26511878 DERIVED

• Steiner D, Renetseder F, Kutz A, Haubitz S, Faessler L, Anderson JB, Laukemann S, Rast AC, Felder S, Conca A, Reutlinger B, Batschwaroff M, Tobias P, Buergi U, Mueller B, Schuetz P. Performance of the Manchester Triage System in Adult Medical Emergency Patients: A Prospective Cohort Study. J Emerg Med. 2016 Apr;50(4):678-89. doi: 10.1016/j.jemermed.2015.09.008. Epub 2015 Oct 14.

  PMID: 26458788 DERIVED

• Schuetz P, Hausfater P, Amin D, Haubitz S, Fassler L, Grolimund E, Kutz A, Schild U, Caldara Z, Regez K, Zhydkov A, Kahles T, Nedeltchev K, von Felten S, De Geest S, Conca A, Schafer-Keller P, Huber A, Bargetzi M, Buergi U, Sauvin G, Perrig-Chiello P, Reutlinger B, Mueller B. Optimizing triage and hospitalization in adult general medical emergency patients: the triage project. BMC Emerg Med. 2013 Jul 4;13:12. doi: 10.1186/1471-227X-13-12.

  PMID: 23822525 DERIVED

Biospecimen

Retention: SAMPLES WITHOUT DNA

Left over blood samples of routinely collect blood tubes on admission will be asserved and aliquoted for later batch analysis of blood biomarkers (bio-bank)

MeSH Terms

Conditions

Emergencies

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Philipp Schütz, PD Dr. med.

  Medical University Clinic, Kantonsspital Aarau, Switzerland

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PD Dr.med.

Study Record Dates

• First Submitted: January 9, 2013
• First Posted: January 15, 2013
• Study Start: March 1, 2013
• Primary Completion: October 1, 2014
• Study Completion: October 1, 2014
• Last Updated: December 12, 2014

Record last verified: 2014-12

Locations

CH (1)