Clinical trial NCT03108807: National Early Warning Score and D-dimer to Identify Medical Patients At Low Risk of 30-day Mortality
Official title: Combined Use of the National Early Warning Score and D-dimer to Identify Medical Patients At Low Risk of 30-day Mortality in a Danish Emergency Department
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Medical Patients in the Emergency Department
Keywords: Emergency Department
Medical patients
D-dimer
National Early Warning Score
NEWS
30-days mortality
Mortality
Lead sponsor: Esbjerg Hospital - University Hospital of Southern Denmark
Sponsor class: OTHER
Collaborators: name: University of Southern Denmark
First posted: 2017-04-11
Enrollment: 1700
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: An unselected group of consecutive patients in a Danish Emergency Department.

Brief summary: The aim is to determine if the National Early Warning Score combined with plasma D-dimer levels can be used in risk stratification of acutely ill medical patients presenting to a Danish Emergency Department. The investigators wish to identify patients at low risk of mortality within 30 days.

Detailed description: Large increases in emergency admissions are raising concerns about whether all admissions are necessary. If there was a fast and reliable system that could be used to determine the risk of all medical patients, many low-risk patients could be safely returned to primary care or outpatient follow-up clinics.

The investigators wish to determine, if the combination of the National Early Warning Score and plasma D-dimer levels can be used to identify patients at low risk of mortality within 30 days in an unselected group of medical patients presenting to a Danish Emergency Department.

This is a prospective observational study that will be performed on adult medical patients referred to the Emergency Department of a Danish hospital to be assessed for possible admission. The study will be performed in the Emergency Department of Hospital of South West Jutland in the region of Southern Denmark.

Eligibility criteria: Inclusion Criteria:

* Admission to the Emergency Department of Hospital of South West Jutland
* Requirement of any blood test
* Age 18 years
* Informed consent given

Exclusion Criteria:

* Age 18 years
* Informed consent not given

Primary outcomes:
measure: 30-days mortality
timeFrame: 30 days
Secondary outcomes:
measure: Hospital length of stay (LOS)
timeFrame: 30 days
measure: Readmissions within 30 days
timeFrame: 30 days
Other outcomes:
Locations:
city: Esbjerg
country: Denmark
facility: Hospital of South West Jutland
Study officials:
affiliation: Esbjerg Hospital - University Hospital of Southern Denmark
name: Mikkel Brabrand, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Nickel CH, Kuster T, Keil C, Messmer AS, Geigy N, Bingisser R. Risk stratification using D-dimers in patients presenting to the emergency department with nonspecific complaints. Eur J Intern Med. 2016 Jun;31:20-4. doi: 10.1016/j.ejim.2016.03.006. Epub 2016 Apr 1.
citation: Nickel CH, Kellett J, Cooksley T, Bingisser R, Henriksen DP, Brabrand M. Combined use of the National Early Warning Score and D-dimer levels to predict 30-day and 365-day mortality in medical patients. Resuscitation. 2016 Sep;106:49-52. doi: 10.1016/j.resuscitation.2016.06.012. Epub 2016 Jun 20.
citation: Nickel CH, Kellett J, Nieves Ortega R, Lyngholm L, Wasingya-Kasereka L, Brabrand M. Mobility Identifies Acutely Ill Patients at Low Risk of In-Hospital Mortality: A Prospective Multicenter Study. Chest. 2019 Aug;156(2):316-322. doi: 10.1016/j.chest.2019.04.001. Epub 2019 Apr 11.