Koyama Toru, Kashima Takeshi, Yamamoto Motoyoshi, Ouchi Kenjiro, Kotoku Takayuki, Mizuno Yuta
Department of Emergency and Critical Care Medicine Aizawa Hospital Nagano Japan.
Acute Med Surg. 2017 Mar 13;4(3):262-270. doi: 10.1002/ams2.266. eCollection 2017 Jul.
The purpose of this study was to better understand the effects of introducing the Japan Triage and Acuity Scale (JTAS) in the emergency room for walk-in patients.
A simple triage was used in Term A (from April 2006 to December 2010, 4 years and 9 months) and the JTAS was introduced in Term B (from January 2011 to September 2015, 4 years and 9 months). The number of patients who had a sudden turn for the worse after arrival in the emergency room and the time between attendance and emergency catheterization (TBAEC) due to acute coronary syndrome were reviewed.
There were 653 patients in Term A and 626 patients in Term B who were finally diagnosed as having serious causes. There was no significant difference in the frequency of a sudden turn for the worse between the two terms. There were 182 patients in Term A and 167 patients in Term B who underwent emergency catheterization due to acute coronary syndrome. When ST elevation was recognized in the first electrocardiogram, the median time between attendance and medical attention during Term B improved significantly, by 4.5 min. However, there was no significant difference in medians for TBAEC. When ST elevation was not recognized, there was no significant difference between the two terms, neither in terms of median time between attendance and medical attention, nor TBAEC.
The data suggests that the effects of introducing the JTAS in the emergency room were restrictive in these two aspects.
本研究旨在更好地了解在急诊室对非预约患者引入日本分诊及 acuity 量表（JTAS）的效果。
在 A 期（2006 年 4 月至 2010 年 12 月，共 4 年 9 个月）采用简单分诊，在 B 期（2011 年 1 月至 2015 年 9 月，共 4 年 9 个月）引入 JTAS。回顾了患者到达急诊室后病情突然恶化的人数以及因急性冠状动脉综合征就诊至紧急导管插入术（TBAEC）的时间。
A 期有 653 例患者，B 期有 626 例患者最终被诊断为有严重病因。两期病情突然恶化的频率无显著差异。A 期有 182 例患者、B 期有 167 例患者因急性冠状动脉综合征接受了紧急导管插入术。当首次心电图识别出 ST 段抬高时，B 期就诊至医疗处理的中位时间显著改善，缩短了 4.5 分钟。然而，TBAEC 的中位数无显著差异。当未识别出 ST 段抬高时，两期在就诊至医疗处理的中位时间和 TBAEC 方面均无显著差异。
数据表明在急诊室引入 JTAS 在这两个方面的效果有限。
