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Use of the prognostic biomarker suPAR in the emergency department improves risk stratification but has no effect on mortality: a cluster-randomized clinical trial (TRIAGE III)

Overview of attention for article published in Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, August 2018
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Title
Use of the prognostic biomarker suPAR in the emergency department improves risk stratification but has no effect on mortality: a cluster-randomized clinical trial (TRIAGE III)
Published in
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, August 2018
DOI 10.1186/s13049-018-0539-5
Pubmed ID
Authors

Martin Schultz, Line Jee Hartmann Rasmussen, Malene H. Andersen, Jakob S. Stefansson, Alexander C. Falkentoft, Morten Alstrup, Andreas Sandø, Sarah L. K. Holle, Jeppe Meyer, Peter B. S. Törnkvist, Thomas Høi-Hansen, Erik Kjøller, Birgitte Nybo Jensen, Morten Lind, Lisbet Ravn, Thomas Kallemose, Theis Lange, Lars Køber, Lars Simon Rasmussen, Jesper Eugen-Olsen, Kasper Karmark Iversen

Abstract

Risk stratification of patients in the emergency department can be strengthened using prognostic biomarkers, but the impact on patient prognosis is unknown. The aim of the TRIAGE III trial was to investigate whether the introduction of the prognostic and nonspecific biomarker: soluble urokinase plasminogen activator receptor (suPAR) for risk stratification in the emergency department reduces mortality in acutely admitted patients. The TRIAGE III trial was a cluster-randomized interventional trial conducted at emergency departments in the Capitol Region of Denmark. Eligible hospitals were required to have an emergency department with an intake of acute medical and surgical patients and no previous access to suPAR measurement. Three emergency departments were randomized; one withdrew shortly after the trial began. The inclusion period was from January through June of 2016 consisting of twelve cluster-periods of 3-weeks alternating between intervention and control and a subsequent follow-up of ten months. Patients were allocated to the intervention if they arrived in interventional periods, where suPAR measurement was routinely analysed at arrival. In the control periods suPAR measurement was not performed. The main outcome was all-cause mortality 10 months after arrival of the last patient in the inclusion period. Secondary outcomes included 30-day mortality. The trial enrolled a consecutive cohort of 16,801 acutely admitted patients; all were included in the analyses. The intervention group consisted of 6 cluster periods with 8900 patients and the control group consisted of 6 cluster periods with 7901 patients. After a median follow-up of 362 days, death occurred in 1241 patients (13.9%) in the intervention group and in 1126 patients (14.3%) in the control group. The weighted Cox model found a hazard ratio of 0.97 (95% confidence interval, 0.89 to 1.07; p = 0.57). Analysis of all subgroups and of 30-day all-cause mortality showed similar results. The TRIAGE III trial found no effect of introducing the nonspecific and prognostic biomarker suPAR in emergency departments on short- or long-term all-cause mortality among acutely admitted patients. Further research is required to evaluate how prognostic biomarkers can be implemented in routine clinical practice. clinicaltrials.gov, NCT02643459 . Registered 31 December 2015.

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Mendeley readers

The data shown below were compiled from readership statistics for 41 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 41 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 8 20%
Researcher 6 15%
Student > Bachelor 5 12%
Student > Ph. D. Student 5 12%
Other 4 10%
Other 8 20%
Unknown 5 12%
Readers by discipline Count As %
Medicine and Dentistry 13 32%
Nursing and Health Professions 10 24%
Psychology 2 5%
Biochemistry, Genetics and Molecular Biology 1 2%
Unspecified 1 2%
Other 3 7%
Unknown 11 27%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 August 2018.
All research outputs
#11,917,642
of 13,441,462 outputs
Outputs from Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
#805
of 853 outputs
Outputs of similar age
#229,917
of 266,604 outputs
Outputs of similar age from Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
#1
of 1 outputs
Altmetric has tracked 13,441,462 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 853 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.4. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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