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Modification and Validation of a Complaint-Oriented Emergency Department Triage System: A Multicenter Observational Study

PURPOSE: The objective of this study was to modify and validate an emergency department (ED) triage system with improved prediction performance on hospital outcomes by modifying the Korean Triage and Acuity Scale (KTAS). MATERIALS AND METHODS: We performed a retrospective observational study at thre...

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Autores principales: Choi, Dong Hyun, Hong, Won Pyo, Song, Kyoung Jun, Kim, Tae Han, Shin, Sang Do, Hong, Ki Jeong, Park, Jeong Ho, Jeong, Joo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Yonsei University College of Medicine 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8612858/
https://www.ncbi.nlm.nih.gov/pubmed/34816645
http://dx.doi.org/10.3349/ymj.2021.62.12.1145
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author Choi, Dong Hyun
Hong, Won Pyo
Song, Kyoung Jun
Kim, Tae Han
Shin, Sang Do
Hong, Ki Jeong
Park, Jeong Ho
Jeong, Joo
author_facet Choi, Dong Hyun
Hong, Won Pyo
Song, Kyoung Jun
Kim, Tae Han
Shin, Sang Do
Hong, Ki Jeong
Park, Jeong Ho
Jeong, Joo
author_sort Choi, Dong Hyun
collection PubMed
description PURPOSE: The objective of this study was to modify and validate an emergency department (ED) triage system with improved prediction performance on hospital outcomes by modifying the Korean Triage and Acuity Scale (KTAS). MATERIALS AND METHODS: We performed a retrospective observational study at three academic universities in South Korea. The KTAS code, determined by the chief complaint and the selected modifier of a patient, was used to derive the Modified KTAS (MKTAS). We calculated the area under the receiver operating characteristics curve (AUC) and the test characteristics to evaluate the performance of MKTAS to predict hospital mortality, critical outcome, and admission. RESULTS: A total of 272402 and 128831 ED visits were used for the derivation and validation of MKTAS, respectively. Compared to KTAS, MKTAS had significantly higher AUC values for the prediction of hospital mortality [MKTAS 0.826 (0.818–0.835) vs. KTAS 0.794 (0.784–0.803)], critical outcome [MKTAS 0.836 (0.830–0.841) vs. 0.798 (0.792–0.804)], and admission [MKTAS 0.725 (0.723–0.728) vs. KTAS 0.685 (0.682–0.688)]. The sensitivity for predicting hospital mortality and critical outcome, as well as the specificity for predicting admission, were significantly improved. CONCLUSION: MKTAS was derived by modifying the KTAS, and then validated. Compared with KTAS, MKTAS showed better discriminating ability to predict hospital outcomes. Continuous efforts to evaluate and modify widely used triage systems are required to improve their performance.
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spelling pubmed-86128582021-12-07 Modification and Validation of a Complaint-Oriented Emergency Department Triage System: A Multicenter Observational Study Choi, Dong Hyun Hong, Won Pyo Song, Kyoung Jun Kim, Tae Han Shin, Sang Do Hong, Ki Jeong Park, Jeong Ho Jeong, Joo Yonsei Med J Original Article PURPOSE: The objective of this study was to modify and validate an emergency department (ED) triage system with improved prediction performance on hospital outcomes by modifying the Korean Triage and Acuity Scale (KTAS). MATERIALS AND METHODS: We performed a retrospective observational study at three academic universities in South Korea. The KTAS code, determined by the chief complaint and the selected modifier of a patient, was used to derive the Modified KTAS (MKTAS). We calculated the area under the receiver operating characteristics curve (AUC) and the test characteristics to evaluate the performance of MKTAS to predict hospital mortality, critical outcome, and admission. RESULTS: A total of 272402 and 128831 ED visits were used for the derivation and validation of MKTAS, respectively. Compared to KTAS, MKTAS had significantly higher AUC values for the prediction of hospital mortality [MKTAS 0.826 (0.818–0.835) vs. KTAS 0.794 (0.784–0.803)], critical outcome [MKTAS 0.836 (0.830–0.841) vs. 0.798 (0.792–0.804)], and admission [MKTAS 0.725 (0.723–0.728) vs. KTAS 0.685 (0.682–0.688)]. The sensitivity for predicting hospital mortality and critical outcome, as well as the specificity for predicting admission, were significantly improved. CONCLUSION: MKTAS was derived by modifying the KTAS, and then validated. Compared with KTAS, MKTAS showed better discriminating ability to predict hospital outcomes. Continuous efforts to evaluate and modify widely used triage systems are required to improve their performance. Yonsei University College of Medicine 2021-12 2021-11-16 /pmc/articles/PMC8612858/ /pubmed/34816645 http://dx.doi.org/10.3349/ymj.2021.62.12.1145 Text en © Copyright: Yonsei University College of Medicine 2021 https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Choi, Dong Hyun
Hong, Won Pyo
Song, Kyoung Jun
Kim, Tae Han
Shin, Sang Do
Hong, Ki Jeong
Park, Jeong Ho
Jeong, Joo
Modification and Validation of a Complaint-Oriented Emergency Department Triage System: A Multicenter Observational Study
title Modification and Validation of a Complaint-Oriented Emergency Department Triage System: A Multicenter Observational Study
title_full Modification and Validation of a Complaint-Oriented Emergency Department Triage System: A Multicenter Observational Study
title_fullStr Modification and Validation of a Complaint-Oriented Emergency Department Triage System: A Multicenter Observational Study
title_full_unstemmed Modification and Validation of a Complaint-Oriented Emergency Department Triage System: A Multicenter Observational Study
title_short Modification and Validation of a Complaint-Oriented Emergency Department Triage System: A Multicenter Observational Study
title_sort modification and validation of a complaint-oriented emergency department triage system: a multicenter observational study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8612858/
https://www.ncbi.nlm.nih.gov/pubmed/34816645
http://dx.doi.org/10.3349/ymj.2021.62.12.1145
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