Evidence map›Paper›PMID 40179077›Full record

Observational studyPloS one2025

Characteristics of Dutch ED patients and their journey through the acute care chain: A province-wide flash-mob study.

Lieke Claassen, Patricia Maria Stassen, Thimo Jozef Theresia Boumans, Dennis Gerard Barten, Marjolein Nel Tinie Kremers, Anne Maria Elisa Hermans, Noortje Zelis, Jochen Wilco Lennert Cals, Gideon Hubertus Petrus Latten

Registry-linked trialAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06079099 (Time Within the Acute Care Chain), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06079099 completednot on this map

Time Within the Acute Care Chain: How Long Have Medical Emergency Department Patients Spent

TypeobservationalSponsorMaastricht University Medical CenterRan2022 to 2022Enrolled583ConditionsEmergencies
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Patient-Physician Agreement on Diagnosis in the ED, Part of Diagnostic Excellence. A Prospective Multicenter Study.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Lieke ClaassenDepartment of Emergency Medicine, Zuyderland Medical Centre, Heerlen, The Netherlands.ORCID https://orcid.org/0000-0003-4294-4213
Patricia Maria StassenSection Acute Medicine, Division General Medicine, Department of Internal Medicine, CARIM School of Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
Thimo Jozef Theresia BoumansDepartment of Emergency Medicine, Zuyderland Medical Centre, Heerlen, The Netherlands.
Dennis Gerard BartenDepartment of Emergency Medicine, VieCuri Medical Centre, Venlo, The Netherlands.
Marjolein Nel Tinie KremersDepartment of Emergency Medicine, Sint Jans Gasthuis, Weert, The Netherlands.
Anne Maria Elisa HermansDepartment of Emergency Medicine, VieCuri Medical Centre, Venlo, The Netherlands.
Noortje ZelisSection Acute Medicine, Division General Medicine, Department of Internal Medicine, CARIM School of Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
Jochen Wilco Lennert CalsDepartment of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Gideon Hubertus Petrus LattenDepartment of Emergency Medicine, Zuyderland Medical Centre, Heerlen, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInsight in characteristics and journey of patients in the Acute Care Chain (ACC) who visit the Emergency Department (ED) is lacking. Existing studies focus on prespecified (time-sensitive) complex conditions like major trauma and stroke, and on the hospital phase. This study provides a representative overview of adult ED patients and their journey through the ACC with focus on differences between those with and without prespecified complex conditions.

methodsA prospective 72-hour flash-mob study was conducted in 2022 across all six EDs in the province of Limburg, the Netherlands, encompassing unselected adult patients. Baseline characteristics, journey, and time within ACC were collected. Patients with a prespecified complex condition (stroke, myocardial infarction, aortic syndrome and major trauma) were compared to those without.

resultsOut of 794 adult ED patients, 585 (73.7%) were included. Patients reported symptoms for a median of 1 day (IQR 0-4) before their ED visit; 56.3% encountered ≥ 1 healthcare provider. General practitioners referred 56.1% of patients, and emergency medical services transported 32.9%. The median time in ACC was 5.0 hours (IQR 3.5-6.9), with 3.0 hours (IQR 2.0-4.2) spent in the ED. The three most prevalent presenting complaints were minor trauma (28.5%), abdominal pain (14.6%) and dyspnoea (12.5%), while 9.3% presented with prespecified complex conditions. Patients with a prespecified complex condition were more often triaged highly urgent (53.6% vs 13.9%, p < 0.001) and received a complex work-up (79.6% vs 41.2%, p < 0.001).

conclusionIn our province-wide study, ED patients had symptoms for 1 day and over half of them already contacted a healthcare provider. Time in ACC was 5 hours, with a substantial proportion of time spent prehospitally. Prespecified complex conditions accounted for less than 1 in 10 ED patients. These findings highlight that, to optimise care and care policy, it is essential to examine the entire ACC for unselected patients.

trial registrationClinicalTrials.gov NCT06079099.

Indexed as

Emergency Medical ServicesEmergency Service, HospitalAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedNetherlandsProspective Studies

Identifiers

PMID40179077
PMCPMC11967924

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.