Akershus Cardiac Examination 4 Study (ACE4)
Heart Failure, Tachypnea
About this trial
This is an interventional prevention trial for Heart Failure focused on measuring biomarker, tachypnea, heart failure, echocardiography
Eligibility Criteria
Inclusion Criteria: Patients ≥18 years old Tachypnea (respiratory rate ≥20/min) Admission to Departments under the Division of Medicine at Akershus University Hospital, except the Department of Neurology <24 h from hospital admittance to inclusion in the study Signed written informed consent during the initial phase of the hospitalization Exclusion Criteria: Previously included into the study (in case of patients presenting with a second hospitalization during the study period) Known or suspected cancer outside of local control, documented in medical records, at the time of patient inclusion or diagnosed in relation to the index hospitalization Neurological condition with short life expectancy; e.g. ALS, documented in medical records during screening prior to study entry Other non-cardiac disease with life expectancy below 1 year, documented in medical records during screening prior to study entry Obvious non-cardiac cause for tachypnea based on medical records and clinical findings during screening prior to study entry; e.g. anaphylaxis in young patient with known allergy, dyspnea after direct chest trauma, or young patient with fever and positive Covid-19 test on admission. Patient assessed as non-Internal Medicine patient; e.g. surgical patient Patients unwilling or unable to comply with the protocol, including Glasgow Coma Scale <13 on the time of study inclusion Patients that are intubated for invasive ventilatory therapy before or shortly after hospital admission History of non-compliance to medical management and patients who are considered potentially unreliable, based on documentation in medical records, during screening prior to study entry History or evidence of alcohol or drug abuse with the last 12 months, based on medical records and clinical findings during screening prior to study entry, that will influence study participation Any surgical or medical condition, based on medical records and clinical findings during screening prior to study entry, that will impair the ability of the patient to participate in the study
Sites / Locations
- Akershus University HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Early biomarker-based cardiological assessment and structured feedback in the EHR
Standard of care
We will perform cardiac biomarker testing with NT-proBNP and hs-cTnT measurements on emergency department admission in all participants, regardless of randomization status. The results will be provided in the patient's EHR, regardless of randomization status. For patients randomized to the intervention group, we will provide a note in the patient's EHR that includes assessment of probability that myocardial injury or dysfunction are the underlying pathophysiology responsible for tachypnea, as evaluated by the cardiac biomarker algorithm of the study. We will inform on general recommendations for work up and treatment.
Routine standard of care according to the treating physician