Short summary

In the ELDER trial, we explore benefits and harms related to treatment in a Short Stay Unit (fast track care) for elderly medical patients compared to standard hospitalisation.

Trial Registration: ClinicalTrials.gov Identifier: NCT02395718.

Rationale

Short Stay Units (SSU) in conjunction to emergency departments (ED) are increasingly being implemented to provide accelerated care and shorter hospitalization. However, it is not well studied whether short-stay hospitalization, fast track care, is beneficial for elderly medical patients. Therefore, we perform The ELDER trial.

In a single-blinded randomized trial, we allocate patients to either hospitalization in a SSU, the Quick Diagnostic Unit (intervention), or hospitalization at the Department of Internal Medicine (standard care). The study is conducted at Holbaek Hospital, Denmark.

The primary outcome is 90-day all-cause mortality. Secondary outcomes are: length of stay in-hospital, the incidence of complications during hospitalization, in-hospital mortality, number of ward transfers during hospitalization, rate of readmission, change in instrumental activities of daily living, and change of living facility after hospitalization.

Description of the cohort

Eligible participants are patients aged 75 years or over, in need of in-hospital treatment of an acute medical problem, which are stable upon admission as indicated by green tag triage in the ED.

Patients are excluded if they: (1) have previously participated in the trial; (2) are participating in other clinical trials; (3) have no Danish Civil Registration Number; (4) reside abroad; (5) require help getting to the toilet in daily life; (6) are not aware of date, time and location, or own data (name, birth date); or if: (7) there are no beds available in the QDU; (8) informed consent cannot be obtained.

Data and biological material

Data will be obtained from patient interview, electronic patient registries (GS open, OPUS) and The Danish Civil Registration System.

Collaborating researchers and departments

Department of Emergency Medicine, Holbaek Hospital, University of Copenhagen

• PhD-student and Doctor Camilla Strøm
• Doctor Søren Wistisen Rasmussen
• Doctor Kim Hvid Benn Madsen
• Doctor Thomas Andersen Schmidt, DMSci

Department of Anaesthesia. Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen

• Professor Lars Simon Rasmussen, DMSc

Department of Internal Medicine, Holbaek Hospital, University of Copenhagen

• Doctor Henrik Ancher Sørensen