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

Study Overview
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Brief Summary
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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
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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.

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

Conditions
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Intensive Care Units, Emergency Department

Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

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

Secondary Outcome Measures

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

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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intensive care units, emergency department