Worster Andrew, Fernandes Christopher M, Eva Kevin, Upadhye Suneel
Division of Emergency Medicine, McMaster University, Hamilton, Ontario Canada.
Eur J Emerg Med. 2007 Aug;14(4):188-92. doi: 10.1097/MEJ.0b013e3280adc956.
Each of the two most commonly used five-level triage tools in North America, the Emergency Severity Index and the Canadian Triage and Acuity Scale have been used as a measure of emergency department resource utilization in addition to acuity. In both cases, it is believed that patients triaged as having a higher level of acuity require a greater number of emergency department resources. We compared the ability of each tool to predict the emergency department resources for each emergency department visit and associated hospital admission and in-hospital mortality rates.
This is an observational, cohort study of a population-based random sample of patients triaged at two emergency departments over a 4-month period. Correlational analyses were performed to examine the relationship between the triage assessment and: (i) resource utilization, (ii) hospital admission, and (iii) in-hospital mortality.
From 486 patients, analyses revealed the greatest correlation was between Emergency Severity Index and diagnostic resources [-0.54 (95% confidence intervals: -0.58, -0.50)] and the poorest correlation was between Canadian Triage and Acuity Scale and mortality [-0.16 (95% confidence intervals: -0.20, -0.12)]. No statistically significant differences (P<0.005) were observed between each tool 's ability to predict any of the outcomes measured.
No statistically significant difference was observed in the ability of Emergency Severity Index v. 3 and Canadian Triage and Acuity Scale to predict emergency department resource utilization or immediate patient outcomes. This ability is, at best, only moderate indicating that other, more accurate tools than measures of triage acuity are required for this purpose.
北美最常用的两种五级分诊工具，即急诊严重程度指数（Emergency Severity Index）和加拿大分诊与 acuity 量表（Canadian Triage and Acuity Scale），除了用于评估 acuity 外，还被用作衡量急诊科资源利用情况的指标。在这两种情况下，人们认为分诊为 acuity 水平较高的患者需要更多的急诊科资源。我们比较了每种工具预测每次急诊科就诊所需的急诊科资源以及相关住院率和院内死亡率的能力。
这是一项观察性队列研究，对在 4 个月期间于两个急诊科进行分诊的基于人群的随机样本患者进行研究。进行相关性分析以检查分诊评估与以下方面之间的关系：（i）资源利用情况，（ii）住院情况，以及（iii）院内死亡率。
对 486 名患者的分析显示，急诊严重程度指数与诊断资源之间的相关性最强[-0.54（95%置信区间：-0.58，-0.50）]，而加拿大分诊与 acuity 量表与死亡率之间的相关性最差[-0.16（95%置信区间：-0.20，-0.12）]。在每种工具预测所测量的任何结果的能力之间未观察到统计学上的显著差异（P<0.005）。
在预测急诊科资源利用或患者即时结果方面，急诊严重程度指数第 3 版与加拿大分诊与 acuity 量表的能力没有统计学上的显著差异。这种能力充其量也只是中等水平，这表明为此目的需要比分诊 acuity 测量更准确的其他工具。
