Contribution of SuPAR for Patients in a Situation of Uncertainty Downstream of Emergencies

Study Overview
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Brief Summary
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In this study, the investigators will investigate the relationship between the blood level of SuPAR at admission to the emergency department of the Clermont-Ferrand University Hospital, and the outcome of patients after their hospitalization in a short stay unit.

Detailed Description
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SuPAR (Soluble urokinase Plasminogen Activator Receptor) is a non-specific prognostic blood biomarker related to inflammation. An elevated SuPAR value reflects significant chronic inflammation and predicts a risk of negative outcome and even short-term mortality (intra-hospital, 30 days, 90 days). Conversely, a low SuPAR value is a strong indicator of good prognosis and low risk of readmission. It is therefore of interest to know a patient's SuPAR blood level to enable the clinician to decide whether the patient should be admitted or discharged. SuPAR has been shown to be the best prognostic marker associated with the presence and progression of disease and risk of mortality. The use of SuPAR in clinical routine adds significant complementary information to the standard Early Warning Score assessment and to the classical parameters such as CRP, PCT, Lactate, ALT, Bilirubin, and CBC in the pre-admission of acute patients. Patients admitted to the emergency department will receive their usual management. We will test the added value of the SuPAR assay in the prognosis of patients' outcome at discharge.

Official Title
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Contribution of SuPAR for Patients in a Situation of Uncertainty Downstream of Emergencies

Conditions
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Emergencies, Disease, In-hospital Observation

Intervention / Treatment
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* Other: blood supar measurement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient, male or female, over 18 years old Admitted to the emergency department of the Clermont-Ferrand University Hospital for a medical reason, Classified as FRENCH II or III by the nurse organizer of the reception management Necessity of clinical observation in the Short Term Hospitalization Unit for final orientation decision Requires a blood test upon arrival in the emergency department Able to give informed non-opposition to participate in the research. Affiliation to a Social Security system Exclusion Criteria: Patient under guardianship or curatorship Pregnant and breast feeding woman Patient admitted for psychiatric pathology Patient with a limitation of therapeutics Refusal to participate Patient hospitalized because of a particular social context

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

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental<br>Retrospective analysis of the correlation between SuPAR measurement and patient outcome after hospitalization | Other: blood supar measurement<br>* The supar values will be measured afterwards on the tube bottoms of the patients included in the study from their usual collection<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Relationship between blood supar levels and patient outcome at discharge | Relation between blood supar levels measured and patient outcome at discharge evaluated as : return home = good evolution; hospitalization = bad evolution; admission to an intensive care unit or death = unfavorable evolution | When the excepted 150 patients will be included, estimated 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| National Early Warning Score 2 (NEWS2) | Score allowing the classification of the urgency of a patient. The minimum value is 0 and the maximum value is 20. Higher scores mean a worse outcome | Hour 0 | 
| Modified Early Warning Score (MEWS) | Score allowing the classification of the urgency of a patient. The minimum value is 0 and the maximum value is 17. Higher scores mean a worse outcome | Hour 0 | 
| Blood supar levels | the supar values are classifies into three categories : < 3 ng/ml : supports the referral decision. the patient's general condition is good and the prognosis is high 3-6 ng/ml : presence of pathologies and comorbidity factors. readmissions and high mortality beyond 6 months >6 ng/ml : requires special clinical attention, high risk of mortality | When the excepted 150 patients will be included, estimated 6 months | 
| Blood CRP value | the CRP value will be assessed during the blood test performed as part of the classical management when the patient arrives in the emergency room | Hour 0 | 
| Cardiac frequency | cardiac frequency will be evaluated when the patient arrives in the emergency service as part of the classical management | Hour 0 | 
| Respiratory rate | respiratory rate will be evaluated when the patient arrives in the emergency service as part of the classical management | Hour 0 | 
| Temperature | the temperature will be evaluated when the patient arrives in the emergency service as part of the classical management | Hour 0 | 
| Systolic blood pressure | systolic blood pressure will be evaluated when the patient arrives in the emergency service as part of the classical management | Hour 0 | 
| Diastolic blood pressure | diastolic blood pressure will be evaluated when the patient arrives in the emergency service as part of the classical management | Hour 0 | 
| French triage | French Emergency Nurses Classification in Hospitals (FRENCH) ranks priorities from 5 to 1 (from least urgent to most urgent) according to prognosis and complexity/severity of the medical condition | Hour 0 | 
| Main diagnosis retained by the physician | Main diagnosis retained | at the end of hospitalization | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Supar, Patient triage, Emergency