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The Internal Prospective Validation of the Cancer Admission Score (CAS) Prediction Model

Recruiting
Conditions
Oncology
Interventions
Other: Cancer Admission Score Prediction Model
Registration Number
NCT06558487
Lead Sponsor
Erasmus Medical Center
Brief Summary

The goal of this single center prospective observational study is to determine the agreement between the cancer admission score (CAS) predicted disposition and the actual disposition in patients with an active cancer diagnosis visiting the emergency department (ED). The main question it aims to answer are: Is the performance of the CAS good enough to play a potential role in the ED care process. For each participant the CAS will be calculated and compared to the actual outcome.

Detailed Description

The goal of this single center prospective observational study is to determine the agreement between the cancer admission score (CAS) predicted disposition and the actual disposition in patients with an active cancer diagnosis visiting the emergency department (ED). The main question it aims to answer are: Is the performance of the CAS good enough to play a potential role in the ED care process.

The first part of this study is an observational part. For patients with cancer that are presented to the emergency department (ED) the cancer admission score (CAS) will be calculated by the model both after triage and after the first blood results are in. Furthermore, the expected disposition will be asked to the attending nurse after triage and after the first blood results. Finally, the actual disposition will be written down after the patient has left the ED, in combination with ED length of stay (LOS) and the time for the attending physician to reach a decision about the disposition (time-to-disposition) and the time for a patient to leave the ED (time-to-leave).

The second part is the interventional part. In this part we introduce an early bed reservation intervention. The CAS is still calculated for the patient. If the CAS is 80% or higher based on the triage, the attending physician will be alerted and a call to the bed coordinator will be placed to reserve a bed in advance. After the first blood results are known the second CAS will be calculated, if this drops below 70% the reserved bed can be canceled by the attending physician. Similar to the first part, the expected disposition from the attending nurse after triage and after first blood results will be collected. Finally, the actual disposition, ED LOS, time-to-disposition and time-to-leave will be noted.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Patients with solid or hematological malignancies and receiving systemic therapy or having received systemic therapy within the last 3 months.
  • Presented at or admitted from the emergency department for the oncology, hematology neuro- or lung-oncology clinical unit.
Exclusion Criteria
  • <18 years old
  • Only received a surgical intervention as cancer treatment
  • Admitted to the ED for the surgical department

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Cancer patientsCancer Admission Score Prediction ModelAll adult patients with an active cancer diagnosis who visit the emergency department (ED) of the Erasmus University Medical Centre (Erasmus MC).
Primary Outcome Measures
NameTimeMethod
Cancer Admission ScoreThrough study completion, an average of 6 months

Cancer Admission Score (CAS) calculated after triage and after first blood results, ranging from 0 to 100%. The higher the score the greater the change of admission

Agreement between the CAS and the actual dispositionThrough study completion, an average of 6 months

Agreement between the CAS predicted outcome and the actual outcome

DispositionThrough study completion, an average of 6 months

The outcome of a visit to the ED, being either admission or home

Secondary Outcome Measures
NameTimeMethod
ED Length of StayThrough study completion, an average of 6 months

The total time spent in the ED by a patient during their visit

Agreement between expected disposition by nurse and actual dispositionThrough study completion, an average of 6 months

Agreement between the nurse predicted outcome and the actual outcome

time-to-dispositionThrough study completion, an average of 6 months

The average time between patient's arrival at the emergency department (ED) and the decision to disposition

time-to-leaveThrough study completion, an average of 6 months

The average time between the decision to disposition and departure from the ED (either home or ward)

Trial Locations

Locations (1)

Erasmus University Medical Center

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Rotterdam, Zuid-Holland, Netherlands

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