Wed Jun 02 2021

Built in 1932 and becoming a general hospital in 1952, Nikaia Hospital has 615 beds and more than 1,700 staff. It stands as one of the biggest healthcare centers in the Athens-Piraeus area, serving all of Attica. Its proximity to Piraeus port allows it to offer medical services to patients throughout Greece and the Greek islands.

Hospital Greece

On open days, the hospital’s Emergency Department (ED) serves around 1,400 patients, with each spending about eight hours for observation before discharge or admission. The ED’s medical team comprises nine doctors, 15 specialists, and 30 residents who manage triage, resuscitation, fast-track, and COVID-19 areas, while doctors from other specialties handle additional stations. We recently visited Dr. Dimitrios Tsiftsis in Denmark’s Slagelse Hospital ED, where he spent a week to learn about Danish triage methods. Dr. Tsiftsis, a general surgeon and ED head at Nikaia Hospital, Greece, became interested in suPAR, a triage tool, after a 2018 symposium. With years of experience, he’s a leading ED triage expert in Greece.

Nikaia Hospital’s ED was chosen for a new training program in emergency medicine, highlighting its role in advancing emergency care practices.

What sparked your interest in suPAR?
Dr Tsiftsis: ED crowding is a global issue. Upon learning about suPAR, its value in enhancing our current scoring scales and algorithms for faster, safer patient triage became evident.

What’s the biggest challenge in the ED?
Dr Tsiftsis: Introducing emergency medicine and autonomous EDs in Greece presents several challenges during this initial phase. Staffing, changing mindsets, and education are my main focuses.

Why do you see such potential in suPAR as a biomarker?
Dr Tsiftsis: Adding suPAR to our ED biomarkers will improve our prognostic abilities and decision-making about patient discharges, enabling us to safely send more patients home sooner.

How could suPAR be utilized in your hospital?
Dr Tsiftsis: By using suPAR, we can better identify patients in the grey zone who might otherwise be observed for up to 48 hours. With our current overcapacity – 120 patients for 90 beds – suPAR could significantly help in patient stratification.

What steps are needed to integrate suPAR into clinical routines?
Dr Tsiftsis: We must first assess the feasibility of incorporating suPAR, then develop and standardize a protocol for specific patient groups. This will reveal suPAR’s broader potential applications.

What do you expect from suPAR?
Dr Tsiftsis: I anticipate suPAR will reduce admissions by identifying patients who, based on our current tools, would be admitted but could be sent home within the first 48 hours. This would not only save resources but also ensure that we do not miss patients who genuinely need hospitalization. Ultimately, suPAR will help us selectively refer patients for further observation and investigation after ED discharge.

Would you recommend suPAR to other hospitals?
Dr Tsiftsis: While more data is needed for a broad recommendation, I’m confident that suPAR will positively impact ED operations as more departments adopt it in clinical decision-making.

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