Use of D-dimers in the Emergency Department to Identify Adult Patients at Very Low Risk of Mortality for Fast-track Treatment - a Randomized Controlled Study
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 1,538
- 试验地点
- 4
- 主要终点
- Length of stay
研究概览
简要总结
Emergency departments (ED) internationally are treating an increasing number of patients.
Most require hospital services but some could be better cared for on alternative pathways.
D-dimer has some unique properties. It is non-specific and is elevated in many acute condi- tions; but conversely remains normal in the absence of significant disease. Previous studies have shown that having a normal D-dimer on arrival to the emergency department is associated with a very low risk of 30-day all-cause mortality.
The investigators propose a multicenter randomized controlled trial using D-dimer to identify patients at low risk and test if providing this information will change time to discharge disposition by the treating physician.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 18 or above
- •Able to provide oral and written informed consent in Danish
- •Blood tests ordered on arrival as part of standard of care
- •Ambulatory on arrival or walking to the ambulance (i.e., stable independent gait)
- •Normal vital signs (i.e., National Early Warning Score < 3)
排除标准
- •Unstable condition requiring immediate care in the resuscitation area
- •Triage level red (i.e., the most urgent patients)
- •Trauma (minor and major) patients
- •High likelihood of requiring a D-dimer analysis on clinical indications during the current hospital contact (e.g., suspected venous thromboembolic disease) that will be ordered on arrival regardless of this study
- •Previous participation in the study
结局指标
主要结局
Length of stay
时间窗: From arrival to physician decision within 4 hours of arrival
Length of initial emergency department stay (i.e., time from arrival to the emergency department to decision to discharge home or transfer to another department is made (as reported from the treating physician to the study nurse)).
次要结局
- Hospital length of stay(From arrival until final discharge within 1 month)
- Re-contacts to the emergency department within 30 days from arrival for any reason(From arrival until 30-days later)
- 7- and 30-day all-cause mortality from arrival(From arrival until 30-days later)