No registrations found.
ID
Source
Health condition
dyspnea (dyspnoe); amino-terminal pro B-type natriuretic peptide (amino-terminaal pro B-type natriuretisch peptide); costs (kosten); cost-effectiveness (kosteneffectiviteit)
Sponsors and support
Department of Internal Medicine
's Gravendijkwal 230
3015 CE Rotterdam
fund = initiator = sponsor
Intervention
Outcome measures
Primary outcome
1. Time to discharge;
2. Cost of treatment
Secondary outcome
1. Duration of stay at the ED;
2. Proportion of patients admitted to the hospital;
3. Proportion of patients admitted to an intensive or coronary care unit;
4. Specialist consultations;
5. Medical treatment;
6. Diagnostic investigations
Background summary
Elevated amino-terminal pro-B-type natriuretic peptide (NT-proBNP) plasma levels are indicative for heart failure. Assessment of this biomarker in patients with acute dyspnoea presenting to the emergency department may aid diagnostic decision-making; resulting in improved patient care and reduced costs.
We will investigate the cost-effectiveness of introduction of NT-proBNP measurements in patients presenting with acute dyspnoea to the emergency department of the Erasmus MC, Rotterdam, the Netherlands. Subjects will be randomised for either rapid measurement of plasma NT-proBNP or no diagnostic measurement of NT-proBNP. For ruling out heart failure, cut-off values of 11 pmol/l in males and 17 pmol/l in female patients will be used, and for ruling in heart failure a cut-off value of 120 pmol/l. Time to discharge from the hospital and costs related to hospital admission are primary end-points.
Study objective
Diagnostic uncertainty in patients with complaints of shortness of breath presenting to the Emergency Department of a hospital may delay treatment and proper care. In patients with shortness of breath due to heart failure increased plasma levels of NT-pro-B-type natriuretic peptide (NT-proBNP) can be demonstrated. The use of NT-proBNP as a biomarker for heart failure in patients presenting to the emergency department with dyspnea might improve care and reduce length of hospital stay. In our study we will investigate the effect of introduction of NT-proBNP as biomarker for heart failure on treatment, time to discharge and costs.
Intervention
Study-group: Measurement of NT-proBNP plasma level at presentation in the Emergency Department.
Control-group: No measurement of NT-proBNP plasma level at presentation in the Emergency Department. Blood was collected for determination of NT-proBNP levels at the end of the study.
J.H.W. Rutten
's Gravendijkwal 230
Rotterdam 3015 CE
The Netherlands
+31 10-4639222
j.rutten@erasmusmc.nl
J.H.W. Rutten
's Gravendijkwal 230
Rotterdam 3015 CE
The Netherlands
+31 10-4639222
j.rutten@erasmusmc.nl
Inclusion criteria
1. Age 18 years or older;
2. Acute dyspnea as the most prominent complaint
Exclusion criteria
1. Acute dyspnea due to a trauma;
2. Acute dyspnea due to cardiogenic shock;
3. Renal failure requiring dialysis.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| NTR-new | NL931 |
| NTR-old | NTR956 |
| Other | : |
| ISRCTN | ISRCTN28653133 |