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Comprehensive Geriatric Assessment in an Emergency Department (CGA_ED)

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ClinicalTrials.gov Identifier: NCT03786250
Recruitment Status : Recruiting
First Posted : December 25, 2018
Last Update Posted : December 25, 2018
Sponsor:
Collaborator:
Fundació Mutuam Conviure
Information provided by (Responsible Party):
Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau

Brief Summary:

Purpose Frailty and multi-morbidity have been associated with increased pressure on Emergency Departments (ED), higher hospital admissions and more risks for patients arising from the ED stay. The advantages of developing specific attention to frailty in ED have been highlighted. The benefits of these approaches are related to patients but also to organizations. The aim is to present how a Program of Care for Frailty (PCF) in an ED impacts on patient health and flows.

Objective is to analyze the clinical impact of Comprehensive Geriatric Care (CGA) in the Emergency Department (ED) and on patient flows Setting: A tertiary, teaching, 550-bed urban hospital, with 80,000 adult patients/year ED attendances (43%≥65 years). Two periods are compared: First period (before CGA implantation) del 01/04/2016 - 15/04/2016 and second period (after) 01/04/2017 - 15/04/2017


Condition or disease Intervention/treatment
Emergencies Aging Geriatric Assessment Patient Discharge Procedure: Geriatric Assessment

Detailed Description:

Purpose Frailty and multi-morbidity have been associated with increased pressure on Emergency Departments (ED), higher hospital admissions and more risks for patients arising from the ED stay. The advantages of developing specific attention to frailty in ED have been highlighted. The benefits of these approaches are related to patients but also to organizations. The aim is to observe how a Program of Care for Frailty (PCF) in an ED impacts on patient health and flows.

Objective

  1. Analyze the clinical impact of Comprehensive Geriatric Care (CGA) in the Emergency Department (ED).
  2. Analyze the impact on patient flows following the implementation of a Comprehensive Geriatric Assessment in the Emergency Department (ED).

Methods Setting: A tertiary, teaching, 550-bed urban hospital, with 80,000 adult patients/year ED attendances (43%≥65 years).

First period (before CGA implantation) del 01/04/2016 - 15/04/2016 and second period (after) 01/04/2017 - 15/04/2017 Intervention: In the second period, the AGI was carried out by the emergency medical teams. It basically consists of care adapted to the special needs of geriatric patients, with systematic screening of delirium, delirium prevention, early treatment, pain management with scales adapted to chronicity, conciliation of medication to discharge from the emergency department, among others A comparison will be made of health outcomes and patient flows in ED: direct discharge, admission to emergency observation unit, admission to short stay unit, transfer to intermediate hospital, admission, admission to critical care area, death, time spent in the Emergency Department (ED) and in intermediate hospital, mortality during admission at one and six months, re-entry or reconsultation in the Emergency Department at 30 days and six months will be measured.


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Study Type : Observational
Estimated Enrollment : 450 participants
Observational Model: Cohort
Time Perspective: Retrospective
Official Title: Comprehensive Geriatric Assessment in Emergency Department. Impact on Health and Patient Flows
Actual Study Start Date : December 1, 2018
Actual Primary Completion Date : December 1, 2018
Estimated Study Completion Date : December 1, 2019

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Health Checkup


Intervention Details:
  • Procedure: Geriatric Assessment
    Systematic screening of delirium, prevention of delirium, early treatment, pain management with scales adapted to chronicity, conciliation of medication to emergency discharge, among others.
    Other Name: CGA


Primary Outcome Measures :
  1. Number of patients with delirium [ Time Frame: From date of admission until discharge, assessed up to 30 days ]

Secondary Outcome Measures :
  1. Number of patients with pain correctly treated [ Time Frame: From date of admission until discharge, assessed up to 30 days ]


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Ages Eligible for Study:   18 Years to 115 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
All patients older than 65 years, attended in ED during the study periode.
Criteria

Inclusion Criteria:

  • All patients older than 65 years attended in the ED

Exclusion Criteria:

  • None

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03786250


Locations
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Spain
Hospital de la Santa Creu i Sant Pau Recruiting
Barcelona, Spain, 08025
Contact: Mireia Puig, PhD    +34616335291    mpuigc@santpau.cat   
Sponsors and Collaborators
Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau
Fundació Mutuam Conviure

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Responsible Party: Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau
ClinicalTrials.gov Identifier: NCT03786250     History of Changes
Other Study ID Numbers: IIBSP-AGI-2017-14
First Posted: December 25, 2018    Key Record Dates
Last Update Posted: December 25, 2018
Last Verified: December 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau:
Emergency department
Older
Frailty

Additional relevant MeSH terms:
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Emergencies
Disease Attributes
Pathologic Processes