The Safe Fast Track Study
Use of D-dimers in the Emergency Department to Identify Adult Patients at Very Low Risk of Mortality for Fast-track Treatment - a Randomized Controlled Study
Odense University Hospital
1,538 participants
Jan 22, 2024
INTERVENTIONAL
Conditions
Summary
Emergency departments (ED) internationally are treating an increasing number of patients. Most require hospital services but some could be better cared for on alternative pathways. D-dimer has some unique properties. It is non-specific and is elevated in many acute condi- tions; but conversely remains normal in the absence of significant disease. Previous studies have shown that having a normal D-dimer on arrival to the emergency department is associated with a very low risk of 30-day all-cause mortality. The investigators propose a multicenter randomized controlled trial using D-dimer to identify patients at low risk and test if providing this information will change time to discharge disposition by the treating physician.
Eligibility
Inclusion Criteria5
- Age 18 or above
- Able to provide oral and written informed consent in Danish
- Blood tests ordered on arrival as part of standard of care
- Ambulatory on arrival or walking to the ambulance (i.e., stable independent gait)
- Normal vital signs (i.e., National Early Warning Score \< 3)
Exclusion Criteria5
- Unstable condition requiring immediate care in the resuscitation area
- Triage level red (i.e., the most urgent patients)
- Trauma (minor and major) patients
- High likelihood of requiring a D-dimer analysis on clinical indications during the current hospital contact (e.g., suspected venous thromboembolic disease) that will be ordered on arrival regardless of this study
- Previous participation in the study
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Interventions
The investigators will measure a D-dimer test on participants and randomize on informing the physician on the value.
Locations(2)
View Full Details on ClinicalTrials.gov
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NCT06219486