Hospital-acquired disability is an emerging issue in health care and older, frail medical patients at high risk for allegedly premature referral to a nursing home with consecutive depression and further deterioration of mental and physical independence [33]. To find protocol improve hospital management

of patients with lower respiratory tract infections, we have developed a biomarker-enhanced clinical risk score (combining the CURB65 score and proADM) [34,35]. The efficacy and Inhibitors,research,lifescience,medical safety of this score was recently tested in a randomized controlled trial at the Kantonsspital Aarau. Based on these studies focusing on respiratory infections, we hypothesize that adding clinical parameters and prognostic biomarkers to an established triage risk score, such as the MTS, at the very proximal time point of ED admission, has a substantial and clinically relevant potential to improve its performance and Inhibitors,research,lifescience,medical translate into better triage

of patients on admission and during hospitalization. This will help to identify both, high risk patients in need of urgent care and inhospital management and low risk patients where longer waiting times have no detrimental consequences and who can potentially be treated in outpatient, NLC, post-acute or nursing home settings. Importantly, previous efforts to Inhibitors,research,lifescience,medical validate and improve current triage scores in unselected patients across different medical diagnoses presenting to the ED were limited by the isolated focus on the ED, a small sample size and / or small spectrum of medical conditions, and observational “hypothesis-generating” designs only. In addition, no study has investigated whether initial measurement of blood Inhibitors,research,lifescience,medical biomarkers

and/or clinical parameters has the potential to improve patient triage. Thus, a large-scale comprehensive study is warranted to validate previous findings, investigate whether prognostic markers and clinical parameters could improve patient triage from admission to discharge and translate these findings into a new, improved Inhibitors,research,lifescience,medical initial triage system for use in routine clinical care throughout the hospital Parvulin stay. Importantly, we aim to not only focus on medical risk, but also include biopsychological risk scores for post-acute care / nursing needs to enable a more comprehensive assessment of a patient’s situation. Such an enhanced initial patient assessment that supports a clinician’s ability to accurately triage and risk stratify patients has the potential to facilitate early and appropriate therapeutic interventions and prevent unnecessary waiting times, improve important initial triage decisions in regard to site-of-care decisions, help recognize and plan post-acute care needs early for immediate social worker involvement, reduce duration of hospital stays and, overall, optimize allocation of health-care resources, and at the same time decrease mortality and morbidity by focusing the medical attention to high risk subjects.