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Infected Elders in the Emergency Department: Outcomes and Processes of Care

Completed
Conditions
Sepsis
Registration Number
NCT00591955
Lead Sponsor
Ohio State University
Brief Summary

The purpose of this study is to determine factors which predict a complicated hospital course and then to develop from these findings an Emergency Department guideline to assist in knowing who is at highest risk of elderly patients with infection presenting for care.

Detailed Description

The study is looking at how closely physicians adhere to treatment guidelines in caring for elderly patients, and then to determine if there are differences in elderly patient disease symptoms that result in a failure to use guidelines. If this is known, physicians can then be aware of these differences and provide appropriate care.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
213
Inclusion Criteria
  • age 65 or older
  • blood cultures ordered in the Emergency Department
  • admitted to the hospital from the Emergency Department
Exclusion Criteria
  • age less than 65
  • prisoners
  • Patient unable to provide consent and no legally authorized representative available
  • non-English speaking
  • ED visit or admission in the last 7 days for the same condition
  • primary evaluation by the trauma team

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Complicated Clinical course0-30 days from ED visit

The presense of any one of the following will constitute a complicated clinical course:

1. mortality at 30 days

2. requirement for ICU admission or ICU-level care withing first 48 hours

3. positive blood cultures

Secondary Outcome Measures
NameTimeMethod
Inadequate process of careentire length of Emergency Department visit and hospitalization

failure to meet any one of the following will be considered inadequate processes of care:

1. obtain blood cultures prior to antibiotic administration

2. administration of antibiotics within 4 hours of presentation

3. measure serum lactate if patient has severe sepsis in the ED

4. Fluid resuscitation of 20-40cc/kg if mean arterial perssure is \<65mmHg despite fluid resuscitation

Trial Locations

Locations (1)

The Ohio State University Medical Center

🇺🇸

Columbus, Ohio, United States

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