Acutelines: a Dutch emergency department-based data-biobank for multimodal, longitudinal acute care research

Background: High-quality, longitudinal data from the Emergency Department (ED) are essential for understanding acute illness trajectories and for developing clinically deployable prediction models. However, most existing ED datasets are static, limited in modality or disconnected from long-term outcomes or biomaterials. Methods: We describe a two-year sample of Acutelines, a continuously operating ED-based data-biobank infrastructure at the University Medical Center Groningen. Acutelines is embedded in routine care and captures the full acute care trajectory and uses a stepped consent procedure. It integrates demographics, vital signs, laboratory results, diagnoses, treatments, waveforms, patient-reported outcomes, and prospectively collected biomaterials. Data are linked to in-hospital outcomes and post-discharge mortality. Results: The presented dataset comprises 29,314 ED visits from 18,850 adult patients. Clinical variables are available for nearly all visits, with additional data and questionnaires (n=4,963) and biomaterials (n=2,723) collected in predefined subgroups. Associations between early triage features (National Early Warning Score, vital signs, diagnostic categories) and outcomes, illustrate the clinical depth and longitudinal value of the infrastructure. Conclusion: Acutelines is a living, continuously expanding research infrastructure. Its combination of ED-first inclusion, multimodal data, linkage to long-term outcomes, and availability of biomaterials distinguishes it from existing datasets. Acutelines provides a robust foundation for hypothesis generation, translational research, and the development, validation, and benchmarking of data-driven clinical decision support tools and biomarker tests in acute medicine, while its ongoing expansion enables prospective studies and interventional research. Trial registration: Acutelines is registered at ClinicalTrials.gov under trial registration number NCT04615065.