Triage - Symptoms and Other Predictors in an All-comer Emergency Department Population; (EKBB 236/13)

NCT03892551 | Completed

• 1 other identifier: PB_2019_00008; me19Bingisser
• Study Type: observational
• Target: 7,309
• Locations: 1 country
• Sites: 1

Brief Summary

This study is to develop a tool capable of improved risk prediction regarding the 30-day mortality. Based on vital signs, impaired mobility on presentation (IMOP), Clinical Frailty Scale (CFS) and patients' symptomatology three risk categories (low, intermediate, high risk) will be established.

Conditions

Triage Risk Stratification

Keywords

risk prediction; Electronic triage systems (ETS); undertriage; overtriage

Outcome Measures

Primary Outcomes (1)

• 30-day mortality

  30-day mortality is defined as death within 30 days of the day of presentation to the ED

  within 30 days of the day of presentation to the ED

Secondary Outcomes (4)

• Number of hospitalizations

  day of presentation to the ED

• Number of ICU-admissions

  day of presentation to the ED

• Death rate (In-hospital mortality)

  from day of presentation to the ED to day of hospital discharge (assessed within 365 days of the day of presentation to the ED)

• Number of institutionalisations

  within 365 days of the day of presentation to the ED

Study Arms (1)

patients admitted to emergency ward

all patients admitted to the emergency ward and awaiting triage are observed

Other: Assessment of symptoms patients presenting when admitted to ED; Other: Reason for patient presentation at ED; Other: physicians rating of severity of illness; Diagnostic Test: Assessment of vital signs; Other: Clinical Frailty Scale; Other: Impaired mobility on presentation (IMOP); Other: Assessment of suspected diagnosis and differential diagnoses

Interventions

Assessment of symptoms patients presenting when admitted to ED OTHER

Questionnaire with a predefined list of 35 symptoms

patients admitted to emergency ward

Reason for patient presentation at ED OTHER

Exploratory interview assessing reason for patient presentation at ED

patients admitted to emergency ward

physicians rating of severity of illness OTHER

numeric scale ranging from 0 (perfect condition) to 10 (extremely ill)

patients admitted to emergency ward

Assessment of vital signs DIAGNOSTIC_TEST

Assessment of vital signs (heart rate, blood pressure, body temperature, respiration rate, peripheral capillary haemoglobin oxygen saturation)

patients admitted to emergency ward

Clinical Frailty Scale OTHER

Assessment of frailty by Clinical Frailty Scale (CFS): assess patients' frailty level from 1, very fit, to 9, terminally ill

patients admitted to emergency ward

Impaired mobility on presentation (IMOP) OTHER

Assessment of IMOP: defined as being unable to stand unaided or walk without help

patients admitted to emergency ward

Assessment of suspected diagnosis and differential diagnoses OTHER

Assessment of treating physician's suspected diagnosis and differential diagnoses. Answers will be recorded in free text form.

patients admitted to emergency ward

Eligibility Criteria

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

Study Population

Patients presenting to the ED of the University Hospital Basel over a time-course of 9 weeks from 25.03.2019 to 27.05.2019.

You may qualify if:

• patients presenting to the ED of the University Hospital Basel and awaiting triage

You may not qualify if:

• unwillingness to participate
• insufficient ability to communicate with the study personnel.

Sponsors & Collaborators

• University Hospital, Basel, Switzerland: lead

Study Sites (1)

Department of Emergency Medicine, University Hospital Basel

Basel, 4031, Switzerland

Location

Related Publications (2)

• Rueegg M, Nissen SK, Brabrand M, Kaeppeli T, Dreher T, Carpenter CR, Bingisser R, Nickel CH. The clinical frailty scale predicts 1-year mortality in emergency department patients aged 65 years and older. Acad Emerg Med. 2022 May;29(5):572-580. doi: 10.1111/acem.14460. Epub 2022 Apr 23.

  PMID: 35138670 DERIVED

• Kaeppeli T, Rueegg M, Dreher-Hummel T, Brabrand M, Kabell-Nissen S, Carpenter CR, Bingisser R, Nickel CH. Validation of the Clinical Frailty Scale for Prediction of Thirty-Day Mortality in the Emergency Department. Ann Emerg Med. 2020 Sep;76(3):291-300. doi: 10.1016/j.annemergmed.2020.03.028. Epub 2020 Apr 24.

  PMID: 32336486 DERIVED

Study Officials

• Roland Bingisser, Prof. Dr.

  Department of Emergency Medicine, University Hospital Basel

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 20, 2019
• First Posted: March 27, 2019
• Study Start: March 18, 2019
• Primary Completion: November 30, 2020
• Study Completion: November 30, 2020
• Last Updated: May 25, 2022

Record last verified: 2022-05

Locations

CH (1)