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Open Access Study protocol

A prospective registry of emergency department patients admitted with infection

Julian M Williams12*, Jaimi H Greenslade12, Juliet V McKenzie12, Kevin H Chu12, Anthony FT Brown12, David Paterson3 and Jeffrey Lipman2

Author Affiliations

1 Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia

2 School of Medicine, University of Queensland, Brisbane, Australia

3 Faculty of Health Sciences, University of Queensland, Brisbane, Australia

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BMC Infectious Diseases 2011, 11:27  doi:10.1186/1471-2334-11-27

Published: 26 January 2011

Abstract

Background

Patients with infections account for a significant proportion of Emergency Department (ED) workload, with many hospital patients admitted with severe sepsis initially investigated and resuscitated in the ED. The aim of this registry is to systematically collect quality observational clinical and microbiological data regarding emergency patients admitted with infection, in order to explore in detail the microbiological profile of these patients, and to provide the foundation for a significant programme of prospective observational studies and further clinical research.

Methods/design

ED patients admitted with infection will be identified through daily review of the computerised database of ED admissions, and clinical information such as site of infection, physiological status in the ED, and components of management abstracted from patients' charts. This information will be supplemented by further data regarding results of investigations, microbiological isolates, and length of stay (LOS) from hospital electronic databases. Outcome measures will be hospital and intensive care unit (ICU) LOS, and mortality endpoints derived from a national death registry.

Discussion

This database will provide substantial insights into the characteristics, microbiological profile, and outcomes of emergency patients admitted with infections. It will become the nidus for a programme of research into compliance with evidence-based guidelines, optimisation of empiric antimicrobial regimens, validation of clinical decision rules and identification of outcome determinants. The detailed observational data obtained will provide a solid baseline to inform the design of further controlled trials planned to optimise treatment and outcomes for emergency patients admitted with infections.