Usefulness of Capillary Refill Time and Skin Mottling Score to Predict Intensive Care Unit Admission

Study Overview
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Brief Summary
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In the emergency department (ED), the severity assessment of shock is a fundamental step prior to the admission in intensive care unit (ICU). As biomarkers are time consuming to evaluate severity of the micro and macro-circulation alteration, capillary refill time and skin mottling score are 2 simples, available clinical criteria validated to predict mortality in the ICU. The aim of this study is to provide clinical evidence that capillary refill time and skin mottling score assessed in the ED also predict ICU admission of patients with septic or haemorrhagic shock.

Detailed Description
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This trial is an observational, non-randomized controlled study. A total of 1500 patients admitted to the ED for a septic or hemorrhagic shock will be followed. The primary outcome is the admission to the ICU. The study will not impact the treatments provided to each patient. Capillary refill time and skin mottling score will not be taken into account to decide patient's treatments and/or ICU admission. Patients will be followed during their hospital stay in order to precise their destination after ED (home, ICU, ward) and 28- and 90-days mortality after hospital admission.

Official Title
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Contribution of Capillary Refilling Time and Skin Mottling Score to Predict Intensive Care Unit Admission of Patients With Septic or Haemorrhagic Shock Admitted to the Emergency Department

Conditions
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Shock, Septic, Shock, Hemorrhagic

Intervention / Treatment
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* Other: Capillary refill time and skin mottling score measurement at the admission to the emergency department


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age > 18 years Skin mottling score> 2 and/or capillary refill time > 3secondes associated with at least one of the followings measured at the ED admission by the nurse in charge of the patient: Systolic blood pressure < 90mmHg or blood pressure decrease of 30% at least for patients with high blood pressure history Heart rate > 120 beats per minute Respiratory rate > 22 movements per minute Glasgow coma scale < 13. Exclusion Criteria: Age < 18 years Pregnancy Serious co morbid conditions with a not to be reanimated status known at the ED admission Patients with guardianship or curator

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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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Capillary refill time and skin mottling score measurement at the admission to the emergency department|Patients who meet the inclusion criteria and none of the non-inclusion criteria will benefit from capillary refill time and skin mottling score measurement at the admission to the emergency department (ED) and followed during their hospital stay to precise the destination after ED (home, ICU, ward) and 30- and 90-days mortality after hospital admission.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of ICU admission after ED. | The rate of ICU admission after ED will be monitored for each patient | 2 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality on day 30 after hospital admission | The vital status (alive or deceased) will be recorded on day 30 after hospital admission | 30 days | 
| Mortality on day 90 after hospital admission | The vital status (alive or deceased) will be recorded on day 90 after hospital admission | 90 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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shock, sepsis, haemoragy, intensive care unit, prediction