Renouvin-Benat A, Sabatier P, Varenne F, Pagot-Mathis V, Fournie P, Malecaze F, Gallini A, Soler V
Unité de rétine, service d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse cedex, France.
USMR, unité de soutien méthodologique à la recherche clinique, faculté de médecine Purpan, 37, allée Jules-Guesde, 31000 Toulouse, France.
J Fr Ophtalmol. 2018 Oct;41(8):708-717. doi: 10.1016/j.jfo.2017.12.013. Epub 2018 Sep 13.
The steady increase in the number of visits to the various emergency services combined with the decrease in medical demographics, make it necessary to optimize triage of patients to improve their care. The purpose of this study was to evaluate the pertinence of our triage questionnaire in the classification of ophthalmologic emergencies by severity.
We used a monocentric cross-sectional study. From September 5 through September 25 2017, 858 patients who had all been seen in the ophthalmology emergency department of Pierre Paul Riquet Hospital of Toulouse university medical center and had responded to the triage nurse questionnaire were included. According to the symptoms presented or not by the patient, a color code was attributed (GREEN, ORANGE or RED) in order of increasing level of emergency. For each patient, we compared the severity of the final diagnosis by Base Score with the level of emergency established by our questionnaire.
There were 118 "GREEN" patients, 606 "ORANGE" patients and 134 "RED." We were able to analyze 822 patients. 21.65% of patients were correctly classified, 73.36% were overestimated (of which 87.06% by one level and 12.94% by two levels of severity), and 4.99% were underestimated (of which 90.24% by one level and 9.76% by two levels).
Our current triage questionnaire is not sufficiently discriminating for effective triage of ophthalmologic emergencies. It often overestimates minor emergencies, causing a delay in treating other emergencies. We propose a new questionnaire modified according to the results obtained during our study.
前往各类急诊服务的就诊人数稳步增加,同时医疗人口结构有所变化,因此有必要优化患者分诊以改善护理。本研究的目的是评估我们的分诊问卷在按严重程度对眼科急诊进行分类方面的相关性。
我们采用了单中心横断面研究。2017年9月5日至9月25日,纳入了858名在图卢兹大学医学中心皮埃尔·保罗·里凯医院眼科急诊科就诊并回答了分诊护士问卷的患者。根据患者是否出现某些症状,按紧急程度递增顺序分配颜色代码(绿色、橙色或红色)。对于每位患者,我们将最终诊断的严重程度通过基础评分与我们问卷确定的紧急程度进行比较。
有118名“绿色”患者、606名“橙色”患者和134名“红色”患者。我们能够分析822名患者。21.65%的患者被正确分类,73.36%被高估(其中87.06%高估一级,12.94%高估两级严重程度),4.99%被低估(其中90.24%低估一级,9.76%低估两级)。
我们目前的分诊问卷在有效分诊眼科急诊方面区分能力不足。它经常高估轻微急诊,导致其他急诊治疗延误。我们根据研究中获得的结果提出了一份新的问卷。