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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

Plesner, Louis Lind ; Iversen, Anne Kristine Servais ; Langkjær, Sandra ; Nielsen, Ture Lange ; Østervig, Rebecca ; Warming, Peder Emil ; Salam, Idrees Ahmad ; Kristensen, Michael ; Schou, Morten and Eugen-Olsen, Jesper , et al. (2015) In Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 23(1).
Abstract
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... (More)
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 5th 2013 and December 6th 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. (Less)
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publishing date
type
Contribution to journal
publication status
published
in
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
volume
23
issue
1
article number
106
publisher
BioMed Central (BMC)
ISSN
1757-7241
DOI
10.1186/s13049-015-0184-1
language
English
LU publication?
no
id
5a06e5f8-9fb4-4843-ade9-12cabb2f7d6e
date added to LUP
2021-03-29 14:27:10
date last changed
2021-03-30 17:03:41
@article{5a06e5f8-9fb4-4843-ade9-12cabb2f7d6e,
  abstract     = {Background<br>
<br>
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.<br>
Methods<br>
<br>
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.<br>
Results<br>
<br>
Between September 5th 2013 and December 6th 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 &lt; 0.001).<br>
Conclusion<br>
<br>
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.},
  author       = {Plesner, Louis Lind and Iversen, Anne Kristine Servais and Langkjær, Sandra and Nielsen, Ture Lange and Østervig, Rebecca and Warming, Peder Emil and Salam, Idrees Ahmad and Kristensen, Michael and Schou, Morten and Eugen-Olsen, Jesper and Forberg, Jakob Lundager and Køber, Lars and Rasmussen, Lars S and Söletormos, György and Klarlund-Pedersen, Bente and Iversen, Kasper},
  issn         = {1757-7241},
  language     = {eng},
  number       = {1},
  publisher    = {BioMed Central (BMC)},
  series       = {Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine},
  title        = {The formation and design of the TRIAGE study-baseline data on 6005 consecutive patients admitted to hospital from the emergency department},
  url          = {http://dx.doi.org/10.1186/s13049-015-0184-1},
  doi          = {10.1186/s13049-015-0184-1},
  volume       = {23},
  year         = {2015},
}