Evaluation of the Impact of Within-hospital Trajectories of Patients Admitted in Intensive Care Units (ICU) From Emergency Departments (SUREA)

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.

Study Overview

• Status: Completed
• Conditions: Emergency Department; Intensive Care Units

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.

• Study Type: Observational
• Enrollment (Actual): 50000

Contacts and Locations

Study Locations

• France
  • Île-de-France
    • Paris, Île-de-France, France, 75018
      • Emergency Department, Bichat-Claude Bernard Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• 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.

Description

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.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mortality	Mortality in ICU and in other hospital units	throughout the study: 5 years
Rate of direct transfer	Rate of direct transfer from Emergency Unit to ICU	throughout the study: 5 years
Rate of indirect transfer	Rate of indirect transfer from a hospitalization Unit to ICU	throughout the study: 5 years
Duration of stay in emergency department, in ICU and in hospital	Duration of stay in emergency department, in ICU and in hospital	throughout the study: 5 years
Mode of discharge from ICU	Mode of discharge from ICU and direction of patient (home, other structures etc.)	throughout the study: 5 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Severity scores	Severity scores in ICU	throughout the study: 5 years
Use and duration of mechanical ventilation	Use and duration of mechanical ventilation for patient during ICU stay	throughout the study: 5 years
Score of burden of care in ICU	Score of burden of care in ICU	throughout the study: 5 years
Percentage of patients with ICU stay	Percentage of patients with ICU stay	throughout the study: 5 years
Percentage of patients with continuing care	Percentage of patients with continuing care after discharge from the ICU	throughout the study: 5 years
Frequency of dialysis	Frequency of dialysis	throughout the study: 5 years

Collaborators and Investigators

• Sponsor: Assistance Publique - Hôpitaux de Paris
• Investigators: Principal Investigator: Enrique CASALINO, MD, PhD, APHP

Study record dates

Study Major Dates

• Study Start: January 1, 2013
• Primary Completion (Actual): December 1, 2015
• Study Completion (Actual): December 1, 2015

Study Registration Dates

• First Submitted: November 27, 2014
• First Submitted That Met QC Criteria: December 3, 2014
• First Posted (Estimate): December 4, 2014

Study Record Updates

• Last Update Posted (Estimate): February 17, 2016
• Last Update Submitted That Met QC Criteria: February 15, 2016
• Last Verified: February 1, 2016

More Information

Terms related to this study

• Keywords: emergency department; intensive care units
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: NI11013-AOR11114