Clinical trial NCT06558487: The Internal Prospective Validation of the Cancer Admission Score (CAS) Prediction Model
Official title: The Internal Prospective ValidatiON of a PrediCtiOn Model for the Change of AdmIssion for Patient with CaNcer Admitted to the EmerGency Department (ONCOMING Study)
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Oncology
Keywords: cancer care
emergency care
prediction model
admission
Lead sponsor: Erasmus Medical Center
Sponsor class: OTHER
First posted: 2024-08-16
Enrollment: 200
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: All adult patients with an active cancer diagnosis who visit the ED of the Erasmus University Medical Center (Erasmus MC).

Brief summary: The goal of this single center prospective observational study is to determine the agreement between the cancer admission score (CAS) predicted disposition and the actual disposition in patients with an active cancer diagnosis visiting the emergency department (ED). The main question it aims to answer are: Is the performance of the CAS good enough to play a potential role in the ED care process. For each participant the CAS will be calculated and compared to the actual outcome.

Detailed description: The goal of this single center prospective observational study is to determine the agreement between the cancer admission score (CAS) predicted disposition and the actual disposition in patients with an active cancer diagnosis visiting the emergency department (ED). The main question it aims to answer are: Is the performance of the CAS good enough to play a potential role in the ED care process.

The first part of this study is an observational part. For patients with cancer that are presented to the emergency department (ED) the cancer admission score (CAS) will be calculated by the model both after triage and after the first blood results are in. Furthermore, the expected disposition will be asked to the attending nurse after triage and after the first blood results. Finally, the actual disposition will be written down after the patient has left the ED, in combination with ED length of stay (LOS) and the time for the attending physician to reach a decision about the disposition (time-to-disposition) and the time for a patient to leave the ED (time-to-leave).

The second part is the interventional part. In this part we introduce an early bed reservation intervention. The CAS is still calculated for the patient. If the CAS is 80% or higher based on the triage, the attending physician will be alerted and a call to the bed coordinator will be placed to reserve a bed in advance. After the first blood results are known the second CAS will be calculated, if this drops below 70% the reserved bed can be canceled by the attending physician. Similar to the first part, the expected disposition from the attending nurse after triage and after first blood results will be collected. Finally, the actual disposition, ED LOS, time-to-disposition and time-to-leave will be noted.

Eligibility criteria: Inclusion Criteria:

* Patients with solid or hematological malignancies and receiving systemic therapy or having received systemic therapy within the last 3 months.
* Presented at or admitted from the emergency department for the oncology, hematology neuro- or lung-oncology clinical unit.

Exclusion Criteria:

* \<18 years old
* Only received a surgical intervention as cancer treatment
* Admitted to the ED for the surgical department

Primary outcomes:
measure: Cancer Admission Score
timeFrame: Through study completion, an average of 6 months
measure: Disposition
timeFrame: Through study completion, an average of 6 months
measure: Agreement between the CAS and the actual disposition
timeFrame: Through study completion, an average of 6 months
Secondary outcomes:
measure: Agreement between expected disposition by nurse and actual disposition
timeFrame: Through study completion, an average of 6 months
measure: time-to-disposition
timeFrame: Through study completion, an average of 6 months
measure: time-to-leave
timeFrame: Through study completion, an average of 6 months
measure: ED Length of Stay
timeFrame: Through study completion, an average of 6 months
Other outcomes:
measure: Sex
timeFrame: Through study completion, an average of 6 months
measure: Age
timeFrame: Through study completion, an average of 6 months
measure: Type of Cancer
timeFrame: Through study completion, an average of 6 months
measure: Type of Treatment
timeFrame: Through study completion, an average of 6 months
measure: Main Complaint
timeFrame: Through study completion, an average of 6 months
measure: Physical parameters recorded during triage
timeFrame: Through study completion, an average of 6 months
measure: First Blood results
timeFrame: Through study completion, an average of 6 months
Locations:
city: Rotterdam
country: Netherlands
facility: Erasmus University Medical Center
state: Zuid-Holland
Study officials:
affiliation: Erasmus Medical Center
name: Jason den Duijn
role: PRINCIPAL_INVESTIGATOR
References: