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The formation and design of the TRIAGE study - baseline data on 6005 consecutive patients admitted to hospital from the emergency department

BACKGROUND: Patient crowding in emergency departments (ED) is a common challenge and associated with worsened outcome for the patients. Previous studies on biomarkers in the ED setting has focused on identification of high risk patients, and and the ability to use biomarkers to identify low-risk pat...

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Autores principales: Plesner, Louis Lind, Iversen, Anne Kristine Servais, Langkjær, Sandra, Nielsen, Ture Lange, Østervig, Rebecca, Warming, Peder Emil, Salam, Idrees Ahmad, Kristensen, Michael, Schou, Morten, Eugen-Olsen, Jesper, Forberg, Jakob Lundager, Køber, Lars, Rasmussen, Lars S., Sölétormos, György, Pedersen, Bente Klarlund, Iversen, Kasper
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4667414/
https://www.ncbi.nlm.nih.gov/pubmed/26626588
http://dx.doi.org/10.1186/s13049-015-0184-1
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author Plesner, Louis Lind
Iversen, Anne Kristine Servais
Langkjær, Sandra
Nielsen, Ture Lange
Østervig, Rebecca
Warming, Peder Emil
Salam, Idrees Ahmad
Kristensen, Michael
Schou, Morten
Eugen-Olsen, Jesper
Forberg, Jakob Lundager
Køber, Lars
Rasmussen, Lars S.
Sölétormos, György
Pedersen, Bente Klarlund
Iversen, Kasper
author_facet Plesner, Louis Lind
Iversen, Anne Kristine Servais
Langkjær, Sandra
Nielsen, Ture Lange
Østervig, Rebecca
Warming, Peder Emil
Salam, Idrees Ahmad
Kristensen, Michael
Schou, Morten
Eugen-Olsen, Jesper
Forberg, Jakob Lundager
Køber, Lars
Rasmussen, Lars S.
Sölétormos, György
Pedersen, Bente Klarlund
Iversen, Kasper
author_sort Plesner, Louis Lind
collection PubMed
description BACKGROUND: Patient crowding in emergency departments (ED) is a common challenge and associated with worsened outcome for the patients. Previous studies on biomarkers in the ED setting has focused on identification of high risk patients, and and the ability to use biomarkers to identify low-risk patients has only been sparsely examined. The broader aims of the TRIAGE study are to develop methods to identify low-risk patients appropriate for early ED discharge by combining information from a wide range of new inflammatory biomarkers and vital signs, the present baseline article aims to describe the formation of the TRIAGE database and characteristize the included patients. METHODS: We included consecutive patients ≥ 17 years admitted to hospital after triage staging in the ED. Blood samples for a biobank were collected and plasma stored in a freezer (−80 °C). Triage was done by a trained nurse using the Danish Emergency Proces Triage (DEPT) which categorizes patients as green (not urgent), yellow (urgent), orange (emergent) or red (rescusitation). Presenting complaints, admission diagnoses, comorbidities, length of stay, and ‘events’ during admission (any of 20 predefined definitive treatments that necessitates in-hospital care), vital signs and routine laboratory tests taken in the ED were aslo included in the database. RESULTS: Between September 5(th) 2013 and December 6(th) 2013, 6005 patients were included in the database and the biobank (94.1 % of all admissions). Of these, 1978 (32.9 %) were categorized as green, 2386 (39.7 %) yellow, 1616 (26.9 %) orange and 25 (0.4 %) red. Median age was 62 years (IQR 46–76), 49.8 % were male and median length of stay was 1 day (IQR 0–4). No events were found in 2658 (44.2 %) and 158 (2.6 %) were admitted to intensive or intermediate-intensive care unit and 219 (3.6 %) died within 30 days. A higher triage acuity level was associated with numerous events, including acute surgery, endovascular intervention, i.v. treatment, cardiac arrest, stroke, admission to intensive care, hospital transfer, and mortality within 30 days (p < 0.001). CONCLUSION: The TRIAGE database has been completed and includes data and blood samples from 6005 unselected consecutive hospitalized patients. More than 40 % experienced no events and were therefore potentially unnecessary hospital admissions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13049-015-0184-1) contains supplementary material, which is available to authorized users.
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spelling pubmed-46674142015-12-03 The formation and design of the TRIAGE study - baseline data on 6005 consecutive patients admitted to hospital from the emergency department Plesner, Louis Lind Iversen, Anne Kristine Servais Langkjær, Sandra Nielsen, Ture Lange Østervig, Rebecca Warming, Peder Emil Salam, Idrees Ahmad Kristensen, Michael Schou, Morten Eugen-Olsen, Jesper Forberg, Jakob Lundager Køber, Lars Rasmussen, Lars S. Sölétormos, György Pedersen, Bente Klarlund Iversen, Kasper Scand J Trauma Resusc Emerg Med Study Protocol BACKGROUND: Patient crowding in emergency departments (ED) is a common challenge and associated with worsened outcome for the patients. Previous studies on biomarkers in the ED setting has focused on identification of high risk patients, and and the ability to use biomarkers to identify low-risk patients has only been sparsely examined. The broader aims of the TRIAGE study are to develop methods to identify low-risk patients appropriate for early ED discharge by combining information from a wide range of new inflammatory biomarkers and vital signs, the present baseline article aims to describe the formation of the TRIAGE database and characteristize the included patients. METHODS: We included consecutive patients ≥ 17 years admitted to hospital after triage staging in the ED. Blood samples for a biobank were collected and plasma stored in a freezer (−80 °C). Triage was done by a trained nurse using the Danish Emergency Proces Triage (DEPT) which categorizes patients as green (not urgent), yellow (urgent), orange (emergent) or red (rescusitation). Presenting complaints, admission diagnoses, comorbidities, length of stay, and ‘events’ during admission (any of 20 predefined definitive treatments that necessitates in-hospital care), vital signs and routine laboratory tests taken in the ED were aslo included in the database. RESULTS: Between September 5(th) 2013 and December 6(th) 2013, 6005 patients were included in the database and the biobank (94.1 % of all admissions). Of these, 1978 (32.9 %) were categorized as green, 2386 (39.7 %) yellow, 1616 (26.9 %) orange and 25 (0.4 %) red. Median age was 62 years (IQR 46–76), 49.8 % were male and median length of stay was 1 day (IQR 0–4). No events were found in 2658 (44.2 %) and 158 (2.6 %) were admitted to intensive or intermediate-intensive care unit and 219 (3.6 %) died within 30 days. A higher triage acuity level was associated with numerous events, including acute surgery, endovascular intervention, i.v. treatment, cardiac arrest, stroke, admission to intensive care, hospital transfer, and mortality within 30 days (p < 0.001). CONCLUSION: The TRIAGE database has been completed and includes data and blood samples from 6005 unselected consecutive hospitalized patients. More than 40 % experienced no events and were therefore potentially unnecessary hospital admissions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13049-015-0184-1) contains supplementary material, which is available to authorized users. BioMed Central 2015-12-01 /pmc/articles/PMC4667414/ /pubmed/26626588 http://dx.doi.org/10.1186/s13049-015-0184-1 Text en © Plesner et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Study Protocol
Plesner, Louis Lind
Iversen, Anne Kristine Servais
Langkjær, Sandra
Nielsen, Ture Lange
Østervig, Rebecca
Warming, Peder Emil
Salam, Idrees Ahmad
Kristensen, Michael
Schou, Morten
Eugen-Olsen, Jesper
Forberg, Jakob Lundager
Køber, Lars
Rasmussen, Lars S.
Sölétormos, György
Pedersen, Bente Klarlund
Iversen, Kasper
The formation and design of the TRIAGE study - baseline data on 6005 consecutive patients admitted to hospital from the emergency department
title The formation and design of the TRIAGE study - baseline data on 6005 consecutive patients admitted to hospital from the emergency department
title_full The formation and design of the TRIAGE study - baseline data on 6005 consecutive patients admitted to hospital from the emergency department
title_fullStr The formation and design of the TRIAGE study - baseline data on 6005 consecutive patients admitted to hospital from the emergency department
title_full_unstemmed The formation and design of the TRIAGE study - baseline data on 6005 consecutive patients admitted to hospital from the emergency department
title_short The formation and design of the TRIAGE study - baseline data on 6005 consecutive patients admitted to hospital from the emergency department
title_sort formation and design of the triage study - baseline data on 6005 consecutive patients admitted to hospital from the emergency department
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4667414/
https://www.ncbi.nlm.nih.gov/pubmed/26626588
http://dx.doi.org/10.1186/s13049-015-0184-1
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