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Research in acute care faces many challenges, including enrollment challenges, legal limitations in data sharing, limited funding, and lack of singular ownership of the domain of acute care. To overcome some of these challenges, the Center of Acute Care of the University Medical Center Groningen in the Netherlands, has established a de novo data-, image- and biobank named "Acutelines". Acutelines is initiated to improve recognition and treatment of acute diseases and obtain insight in the consequences of acute diseases, including factors predicting its outcome. Thereby, Acutelines contributes to development of personalized treatment and improves prediction of patient outcomes after an acute admission.
Acutelines is a prospective biobank including patients with a broad spectrum of acute conditions. Its aim is to facilitate interdisciplinary research on the etiology and development of acute diseases with the aid of systematically collected biomaterials and medical data over various timepoints, both during the course of the patient's disease and after recovery. Clinical data, imaging data and biomaterial (i.e. blood, urine, feces, hair) are collected for patients presenting to the Emergency Department (ED) with a broad range of acute disease presentations. A deferred consent procedure (by proxy), is in place to allow collecting data and biomaterials prior to obtaining written consent. The digital infrastructure in place and the software used ensures automated capturing of all bed-side monitoring data (i.e. electrophysiological waveforms, vital parameters), and the secure importation of data from other sources, such as the electronic health records of the hospital, ambulance and general practitioner, municipal registration, health insurance companies and pharmacy. Follow up data are collected for all included patients during the first 72-hours of their hospitalization and 3-months, 1-year, 2-years and 5 years after their ED visit.
Data and materials to be collected includes:
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| Measure | Description | Time Frame |
|---|---|---|
| Mortality (time and cause) | Mortality will be retrieved from the electronic health records (EHR) from the hospital and municipal registration. The cause of death will be retrieved from the EHR from the hospital, general practitioner and Dutch statistics' office (CBS). | Until the death of death from any cause, up to 50 years |
| Katz ADL-6 (functioning) | Katz ADL-6 (0-6, fully dependent-independent) | Up to 1 year |
| World Health Organization (WHO) performance status (functioning) | World Health Organization (WHO) performance status (0-4, normal performance-bedridden) | Up to 1 year |
| Karnofsky performance score (functioning) | Karnofsky performance score (10-100, moribund-normal performance) | Up to 1 year |
| Utrecht Activity List (daily activities) | Utrecht Activity List (UAL; hours/week spend on (a) paid work, (b) education, (c) household, (d) running errands, (e) unpaid work, (f) sport, (g) hobbies, (h) other use of leisure time ) | Up to 1 year |
| Short QUestionnaire to ASsess Health-enhancing physical activity (daily activities) | Short QUestionnaire to ASsess Health-enhancing physical activity (SQUASH; minutes/week and intensity of activity spend (a) commuting, (b) at work, (c) household activities and (d) leisure time; increased score corresponds with increased physical activity) | Up to 1 year |
| Quality of Life and experienced symptoms |
| Measure | Description | Time Frame |
|---|---|---|
| Biomarkers | Laboratory values (Hb [mmol/L], leukocytes [/mL), trombocytes [/ml], creatinine [mmol/L], urea [mmol/L], CRP [mg/L], LDL cholesterol [mmol/L], HDL cholesterol [mmol/L], total cholesterol [mmol/L], AST [U/L], ALT [U/L], gGT [U/L], AF [U/L], bilirubin [microl/L], NTproBNP [pg/mL], troponin [microg/L]) will be retrieved from the electronic health records (EHR) from the hospital, general practitioner and pharmacy.](streamdown:incomplete-link) |
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Inclusion Criteria, at least one of the following:
Exclusion Criteria:
While data- and imaging will be collected from all these patients, biomaterials will only be collected from patients fulfilling the first criterion (i.e. triaged as one of highest two triage categories [red or orange] according to the Manchester triage system) and from patients with shock or a suspicion of sepsis.
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Adult patients admitted to the emergency room for emergency medicine, internal medicine [including sub-specializations as allergology, acute medicine, oncology, hematology, infectiology, nephrology, vascular medicine, geriatric medicine], pulmonology, gastro-enterology and rheumatology.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hjalmar Bouma, MD, PhD | Contact | +31 50 361 6161 | acutelines@umcg.nl |
| Name | Affiliation | Role |
|---|---|---|
| Ewoud ter Avest, MD, PhD | University Medical Center Groningen | Study Chair |
| Jan ter Maaten, MD, PhD | University Medical Center Groningen | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Medical Center Groningen | Recruiting | Groningen | 9700 RB | Netherlands |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40906653 | Derived | van der Aart TJ, Luxen M, Koeze J, Londen MV, Hackl M, Ter Maaten JC, van Meurs M, Bouma HR; the Acutelines research group. Validation of plasma microRNAs as biomarkers in sepsis associated acute kidney injury upon first clinical presentation reveals limited diagnostic and prognostic performance. PLoS One. 2025 Sep 4;20(9):e0331442. doi: 10.1371/journal.pone.0331442. eCollection 2025. | |
| 39615435 |
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Individual participant data (IPD) may be available to other researchers if needed for their specific research purposes, which amongst others must be in line with the study protocol, the informed consent form and the general data protection regulations (GDPR). Each request for re-use of data will be reviewed by Acutelines' steering group, manager and local review board (LRb), prior to establishing a material and data transfer agreement (MDTA). No IPD will be shared if not required to answer research question.
Supporting information will become available short after initiation of the study and will remain available until the end of the study (undetermined).
Supporting information will either be made available through the website (http://acutelines.umcg.nl), LinkedIn (https://www.linkedin.com/company/acutelines) and/or upon reasonable request.
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Biomaterials will be collected from:
Biomaterials to be collected are serum, plasma (EDTA), plasma (Lithium heparin), PAXGene RNA, buffy coat (from EDTA), urine, feces, hair
EuroQol-5D (EQ5D; simple descriptive profile and a single index value for health status; higher values corresponding with better health) with visual analogue scale (VAS; 0-100, worse-best experienced health) |
| Up to 1 year |
| Experienced somatic symptoms | Patient Health Questionnaire-15 (PHQ-15; 0-30, minimal-high somatic symptom severity) | Up to 1 year |
| Fatigue | Piper Fatigue Scale-12 (PFS-12; 0-10, higher scores reflect more fatigue among four subscales (a) behavior, (b) affect, (c) sensory, (d) cognition) | Up to 1 year |
| Patient Health Questionnaire-2 (mental health) | Patient Health Questionnaire-2 (PHQ-2; 0-6, higher score corresponds to reduced mental health) | Up to 1 year |
| Patient Health Questionnaire-9 (mental health) | Patient Health Questionnaire-9 (PHQ-9; 0-4 no depressive symptoms, 5-9 mild depressive symptoms, 10-14 moderate depressive symptoms, 15-19 moderately severe depressive symptoms, 20-27 severe depressive symptoms) | Up to 1 year |
| Geriatric Depression scale-15 (mental health) | Geriatric Depression scale-15 (GDS-15; 0-4 no depressive symptoms, 5-10 mild depressive symptoms, 11-15 depressive symptoms) | Up to 1 year |
| Patient satisfaction | Patient Satisfaction Questionnaire Short-form (PSQ-18; measuring general satisfaction, technical quality, interpersonal manner, communication, financial aspects, time spent with doctor, and accessibility and convenience; scored per domain, with lower scores corresponding with higher satisfaction) | Up to 1 year |
| Decision making | Outcome prioritization tool (OPT; 0-100% per domain of prioritization for (a) life extension, (b) preserving independence, (c) reducing pain and (d) reducing other symptoms) | Up to 1 year |
| Co-morbidity | Co-morbidity will be retrieved from the electronic health records (EHR) from the hospital, general practitioner and pharmacy. Data will be registered according to the Charlson' co-morbidity index (CCI; 1-2 mild co-morbidity, 3-4 moderate co-morbidity, 5 severe co-morbidity) | Up to 5 years |
| Length-of-stay in hospital/intensive care unit (ICU) | Length-of-stay in hospital and on intensive care unit (ICU) in days | Until hospital discharge, an average of 2 weeks |
| Up to 5 years |
| Medication use | Medication use will be retrieved from the electronic health records (EHR) from the hospital, general practitioner and pharmacy. | Up to 5 years |
| Treatment (non-pharmacological, including organ support) | Treatment (non-pharmacological) will be retrieved from the electronic health records (EHR) from the hospital, general practitioner and (helicopter) emergency medical service. Data will include intravenous fluid resuscitation, vasopressors, mechanical ventilation/non-invasive ventilation, oxygen supply, acute dialysis and extra-corporeal membrane oxygenation (ECMO) | Until hospital discharge, up to 3 months |
| Sequential organ failure assessment (SOFA) | SOFA scores will be available for patients admitted because of an infection. | Up to 72 hours after hospitalization |
| Vital parameters | Heart rate (bpm), blood pressure (mmHg), oxygen saturation (SpO2, SaO2, PaO2), breathing frequency (per min), consciousness (Glasgow coma scale), pain score (VAS), nausea/vomiting (y/n), defecation (y/n), urination (y/n), body weight (kg), length (cm), fluid balance (ml/day). | Until hospital discharge, up to 3 months |
| Hjalmar Bouma, MD, PhD |
| University Medical Center Groningen |
| Study Director |
| Derived |
| van der Aart TJ, Visser M, van Londen M, van de Wetering KMH, Ter Maaten JC, Bouma HR; Acutelines research group. The smell of sepsis: Electronic nose measurements improve early recognition of sepsis in the ED. Am J Emerg Med. 2025 Feb;88:126-133. doi: 10.1016/j.ajem.2024.11.045. Epub 2024 Nov 26. |
| 34266842 | Derived | Ter Avest E, van Munster BC, van Wijk RJ, Tent S, Ter Horst S, Hu TT, van Heijst LE, van der Veer FS, van Beuningen FE, Ter Maaten JC, Bouma HR. Cohort profile of Acutelines: a large data/biobank of acute and emergency medicine. BMJ Open. 2021 Jul 15;11(7):e047349. doi: 10.1136/bmjopen-2020-047349. |
| ID | Term |
|---|---|
| D000208 | Acute Disease |
| D018805 | Sepsis |
| D011014 | Pneumonia |
| D000073496 | Frailty |
| D011655 | Pulmonary Embolism |
| D013927 | Thrombosis |
| D058186 | Acute Kidney Injury |
| D006470 | Hemorrhage |
| D012769 | Shock |
| D004630 | Emergencies |
| D014552 | Urinary Tract Infections |
| D002481 | Cellulitis |
| D013575 | Syncope |
| D000707 | Anaphylaxis |
| D004417 | Dyspnea |
| D003441 | Crowding |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007239 | Infections |
| D018746 | Systemic Inflammatory Response Syndrome |
| D007249 | Inflammation |
| D012141 | Respiratory Tract Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D004617 | Embolism |
| D016769 | Embolism and Thrombosis |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D012874 | Skin Diseases, Infectious |
| D013492 | Suppuration |
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D014474 | Unconsciousness |
| D003244 | Consciousness Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
| D012120 | Respiration Disorders |
| D012818 | Signs and Symptoms, Respiratory |
| D013037 | Spatial Behavior |
| D001519 | Behavior |
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