Evaluation of the Impact of Within-hospital Trajectories of Patients Admitted in Intensive Care Units (ICU) From Emergency Departments

Completed

• Conditions: Emergency Department; Intensive Care Units

• Registration Number: NCT02307136
• Lead Sponsor: Assistance Publique - Hôpitaux de Paris

Brief Summary

This multicenter cohort aims to assess the impact of within-hospital trajectories of patients admitted in intensive care units from emergency departments on vital prognosis of patients, duration of hospital stay and hospital costs.

As secondary objectives, the study will:

* assess the impact of clinical and demographic characteristics on hospital trajectories of patients.

* assess the impact of emergency units workload, beds availability in medical units and in intensive care units, and global hospital organisation on patients care trajectories.

Detailed Description

The study will be performed in emergency departments and ICUs of university hospitals. 15 emergency departments and 36 ICUs of APHP (the public hospital system of the city of Paris) will be involved.

The study will assemble the data from 50,000 to 80,000 patients in total.

Eligible patients are admitted in ICUs between 01/01/2007 and 12/31/2011.

Extraction of the patients' data will be performed with processing software utilised in APHP, i.e. Healthcare Information System Program (PMSI, Urqual, Gilda...etc.).

Collected patients' data span the period from admission in emergency department or medical department unitl hospital discharge.

Study Timeline

• Study Start: 2013-01
• Study First Submitted: 2014-11-27
• Study First Submitted QC: 2014-12-03
• Study First Posted: 2014-12-04
• Primary Completion: 2015-12
• Study Completion: 2015-12
• Status Verified: 2016-02
• Last Update Submitted: 2016-02-15
• Last Update Posted: 2016-02-17

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 50000

Inclusion Criteria

• Adult patient directly admitted in ICU from emergency departments of APHP (the public hospital system of the city of Paris).
• Adult patient indirectly transferred to ICU from an hospitalization unit, initially admitted from an emergency department of APHP.

Exclusion Criteria

• Patient transferred from APHP toward an external hospital, outside APHP, before being admitted in an ICU.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Rate of direct transfer	throughout the study: 5 years	Rate of direct transfer from Emergency Unit to ICU
Mode of discharge from ICU	throughout the study: 5 years	Mode of discharge from ICU and direction of patient (home, other structures etc.)
Mortality	throughout the study: 5 years	Mortality in ICU and in other hospital units
Rate of indirect transfer	throughout the study: 5 years	Rate of indirect transfer from a hospitalization Unit to ICU
Duration of stay in emergency department, in ICU and in hospital	throughout the study: 5 years	Duration of stay in emergency department, in ICU and in hospital

Secondary Outcome Measures

Name	Time	Method
Use and duration of mechanical ventilation	throughout the study: 5 years	Use and duration of mechanical ventilation for patient during ICU stay
Score of burden of care in ICU	throughout the study: 5 years	Score of burden of care in ICU
Frequency of dialysis	throughout the study: 5 years	Frequency of dialysis
Severity scores	throughout the study: 5 years	Severity scores in ICU
Percentage of patients with ICU stay	throughout the study: 5 years	Percentage of patients with ICU stay
Percentage of patients with continuing care	throughout the study: 5 years	Percentage of patients with continuing care after discharge from the ICU

Trial Locations

Locations (1)

Emergency Department, Bichat-Claude Bernard Hospital; 🇫🇷 Paris, Île-de-France, France