Cargando…
Validation of a modified South African triage scale in a high-resource setting: a retrospective cohort study
BACKGROUND: Triage systems are widely used in emergency departments, but are not always validated. The South African Triage Scale (SATS) has mainly been studied in resource-limited settings. The aim of this study was to determine the validity of a modified version of the SATS for the general populat...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10026449/ https://www.ncbi.nlm.nih.gov/pubmed/36941710 http://dx.doi.org/10.1186/s13049-023-01076-y |
_version_ | 1784909543571980288 |
---|---|
author | Markussen, Dagfinn Lunde Brevik, Heidi Synnøve Bjørneklett, Rune Oskar Engan, Mette |
author_facet | Markussen, Dagfinn Lunde Brevik, Heidi Synnøve Bjørneklett, Rune Oskar Engan, Mette |
author_sort | Markussen, Dagfinn Lunde |
collection | PubMed |
description | BACKGROUND: Triage systems are widely used in emergency departments, but are not always validated. The South African Triage Scale (SATS) has mainly been studied in resource-limited settings. The aim of this study was to determine the validity of a modified version of the SATS for the general population of patients admitted to an ED at a tertiary hospital in a high-income country. The secondary objective was to study the triage performance according to age and patient categories. METHODS: We conducted a retrospective cohort study of patients presenting to the Emergency Department of Haukeland University Hospital in Norway during a four-year period. We used short-term mortality, ICU admission, and the need for immediate surgery and other interventions as the primary endpoints. RESULTS: A total of 162,034 emergency department visits were included in the analysis. The negative predictive value of a low triage level to exclude severe illness was 99.1% (95% confidence interval: 99.0–99.2%). The level of overtriage, defined as the proportion of patients assigned to a high triage level who were not admitted to the hospital, was 4.1% (3.9–4.2%). Receiver operating characteristic (ROC) curves showed an area under the ROC for the detection of severe illness of 0.874 (95% confidence interval: 0.870–0.879) for all patients and 0.856 (0.837–0.875), 0.884 (0.878–0.890) and 0.869 (0.862–0.876) for children, adults and elderly individuals respectively. CONCLUSION: We found that the modified SATS had a good sensitivity to identify short-term mortality, ICU admission, and the need for rapid surgery and other interventions. The sensitivity was higher in adults than in children and higher in medical patients than in surgical patients. The over- and undertriage rates were acceptable. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13049-023-01076-y. |
format | Online Article Text |
id | pubmed-10026449 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-100264492023-03-21 Validation of a modified South African triage scale in a high-resource setting: a retrospective cohort study Markussen, Dagfinn Lunde Brevik, Heidi Synnøve Bjørneklett, Rune Oskar Engan, Mette Scand J Trauma Resusc Emerg Med Original Research BACKGROUND: Triage systems are widely used in emergency departments, but are not always validated. The South African Triage Scale (SATS) has mainly been studied in resource-limited settings. The aim of this study was to determine the validity of a modified version of the SATS for the general population of patients admitted to an ED at a tertiary hospital in a high-income country. The secondary objective was to study the triage performance according to age and patient categories. METHODS: We conducted a retrospective cohort study of patients presenting to the Emergency Department of Haukeland University Hospital in Norway during a four-year period. We used short-term mortality, ICU admission, and the need for immediate surgery and other interventions as the primary endpoints. RESULTS: A total of 162,034 emergency department visits were included in the analysis. The negative predictive value of a low triage level to exclude severe illness was 99.1% (95% confidence interval: 99.0–99.2%). The level of overtriage, defined as the proportion of patients assigned to a high triage level who were not admitted to the hospital, was 4.1% (3.9–4.2%). Receiver operating characteristic (ROC) curves showed an area under the ROC for the detection of severe illness of 0.874 (95% confidence interval: 0.870–0.879) for all patients and 0.856 (0.837–0.875), 0.884 (0.878–0.890) and 0.869 (0.862–0.876) for children, adults and elderly individuals respectively. CONCLUSION: We found that the modified SATS had a good sensitivity to identify short-term mortality, ICU admission, and the need for rapid surgery and other interventions. The sensitivity was higher in adults than in children and higher in medical patients than in surgical patients. The over- and undertriage rates were acceptable. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13049-023-01076-y. BioMed Central 2023-03-20 /pmc/articles/PMC10026449/ /pubmed/36941710 http://dx.doi.org/10.1186/s13049-023-01076-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Original Research Markussen, Dagfinn Lunde Brevik, Heidi Synnøve Bjørneklett, Rune Oskar Engan, Mette Validation of a modified South African triage scale in a high-resource setting: a retrospective cohort study |
title | Validation of a modified South African triage scale in a high-resource setting: a retrospective cohort study |
title_full | Validation of a modified South African triage scale in a high-resource setting: a retrospective cohort study |
title_fullStr | Validation of a modified South African triage scale in a high-resource setting: a retrospective cohort study |
title_full_unstemmed | Validation of a modified South African triage scale in a high-resource setting: a retrospective cohort study |
title_short | Validation of a modified South African triage scale in a high-resource setting: a retrospective cohort study |
title_sort | validation of a modified south african triage scale in a high-resource setting: a retrospective cohort study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10026449/ https://www.ncbi.nlm.nih.gov/pubmed/36941710 http://dx.doi.org/10.1186/s13049-023-01076-y |
work_keys_str_mv | AT markussendagfinnlunde validationofamodifiedsouthafricantriagescaleinahighresourcesettingaretrospectivecohortstudy AT brevikheidisynnøve validationofamodifiedsouthafricantriagescaleinahighresourcesettingaretrospectivecohortstudy AT bjørneklettruneoskar validationofamodifiedsouthafricantriagescaleinahighresourcesettingaretrospectivecohortstudy AT enganmette validationofamodifiedsouthafricantriagescaleinahighresourcesettingaretrospectivecohortstudy |