Rappaport Faculty of Medicine, Technion-Israel Institute of Technology.
Department of Pediatric Emergency.
Eur J Emerg Med. 2018 Aug;25(4):270-273. doi: 10.1097/MEJ.0000000000000464.
In 2015, the Israeli Ministry of Health issued national guidelines demanding the use of a five-level triage system in pediatric emergency departments (EDs). The present study aimed to evaluate the validity of the Pediatric Canadian Triage Acuity Scale (PedCTAS) in the ED of a tertiary children's hospital in Israel.
A retrospective cohort study of all patients admitted between January 2011 and December 2015 was carried out. The proportion of hospitalization was the primary outcome measure. The secondary outcomes were proportion of admissions to the ICU, proportions of patients who left without being seen (LWBS), and length of stay (LOS) in the ED.
A total of 83 609 patients were included in our analysis. Triage levels 1-5 included 533 (0.6%), 4428 (5.3%), 46 461 (55.6%), 28 510 (34.1%), and 3677 (4.4%) patients, respectively. Hospitalization proportions were 70, 51, 28, 15, and 12% for triage levels 1, 2, 3, 4, and 5, respectively. Admission proportions to ICU were 24.2, 3.05, 0.24, 0.05, and 0.05% for PedCTAS levels 1, 2, 3, 4, and 5, respectively. The proportions of LWBS were 0.001, 0.002, and 0.005% for triage levels 3, 4, and 5, respectively. LOS was shorter as the triage level increased from 2 to 5.
Triage level was predictive of hospitalization, admission to the ICU, and proportions of LWBS and LOS in the ED. The findings suggest validity of the PedCTAS in this cohort. This is the first report of the performance of a triage tool in an Israeli ED.
2015 年，以色列卫生部发布国家指南，要求在儿科急诊部门（ED）使用五级分诊系统。本研究旨在评估儿科加拿大分诊 acuity 量表（PedCTAS）在以色列一家三级儿童医院 ED 的有效性。
对 2011 年 1 月至 2015 年 12 月期间所有入院患者进行回顾性队列研究。住院比例为主要结局指标。次要结局指标包括 ICU 收治比例、未就诊离开（LWBS）患者比例和 ED 停留时间（LOS）。
共纳入 83609 例患者进行分析。1-5 级分诊分别包括 533 例（0.6%）、4428 例（5.3%）、46461 例（55.6%）、28510 例（34.1%）和 3677 例（4.4%）患者。1、2、3、4、5 级分诊的住院比例分别为 70%、51%、28%、15%和 12%。1、2、3、4、5 级 PedCTAS 分别有 24.2%、3.05%、0.24%、0.05%和 0.05%的患者收入 ICU。LWBS 的比例分别为 3 级、4 级和 5 级分诊的 0.001%、0.002%和 0.005%。分诊级别从 2 级升高到 5 级时，LOS 越短。
分诊级别可预测住院、收入 ICU、LWBS 比例和 ED LOS。研究结果表明该分诊工具在本队列中具有有效性。这是以色列 ED 使用分诊工具的首份报告。
