Clinical trial NCT02307136: Evaluation of the Impact of Within-hospital Trajectories of Patients Admitted in Intensive Care Units (ICU) From Emergency Departments
Official title: Evaluation of the Impact of Within-hospital Trajectories of Patients Admitted in Intensive Care Units (ICU) From Emergency Departments
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Intensive Care Units
Emergency Department
Keywords: intensive care units
emergency department
Lead sponsor: Assistance Publique - Hôpitaux de Paris
Sponsor class: OTHER
First posted: 2014-12-04
Enrollment: 50000
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The population under study is formed of patients admitted in 3 types of intensive care units (Medical intensive care unit, Surgical Intensive Care Unit and Cardiac Intensive Care Unit), transferred from emergency departments, either directly, or from another Department such as a Unit of short durations of hospitalization.

Brief summary: 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: 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.

Eligibility criteria: 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.

Primary outcomes:
measure: Mortality
timeFrame: throughout the study: 5 years
measure: Rate of direct transfer
timeFrame: throughout the study: 5 years
measure: Rate of indirect transfer
timeFrame: throughout the study: 5 years
measure: Duration of stay in emergency department, in ICU and in hospital
timeFrame: throughout the study: 5 years
measure: Mode of discharge from ICU
timeFrame: throughout the study: 5 years
Secondary outcomes:
measure: Severity scores
timeFrame: throughout the study: 5 years
measure: Use and duration of mechanical ventilation
timeFrame: throughout the study: 5 years
measure: Score of burden of care in ICU
timeFrame: throughout the study: 5 years
measure: Percentage of patients with ICU stay
timeFrame: throughout the study: 5 years
measure: Percentage of patients with continuing care
timeFrame: throughout the study: 5 years
measure: Frequency of dialysis
timeFrame: throughout the study: 5 years
Other outcomes:
Locations:
city: Paris
country: France
facility: Emergency Department, Bichat-Claude Bernard Hospital
state: Île-de-France
Study officials:
affiliation: APHP
name: Enrique CASALINO, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References: