Anatolian Journal of Emergency Medicine
Yazarlar: Ozlem DİKME, Rıdvan ATİLLA, Nese COLAK ORAY, Gulcim SARACOGLU, Mehmet Can GİRGİN, Pınar Yesim AKYOL
Konular:Tıp
Anahtar Kelimeler:Triage,Reliability,Validity
Özet: Introduction: Triage systems are useful tools to detecting severity of illness in the emergency department’s waiting areas. Because of the lack of similarity in terms of disease and the patient profile each triage system may not be effective in another country. Dokuz Eylul Triage System was developed as a five-level triage system and this paper evaluates validity and reliability of Dokuz Eylul Triage System to use in a tertiary Turkish emergency department. Methods: This study was performed in a tertiary emergency department. Patients with any symptoms who were admitted to the emergency department in one-month period and selected by systematic sampling method were included into the study. Hospital admission, length of stay in the emergency department, 48h mortality, resource uses were assessed for validity and blinded paired triage assignments were compared with weighted kappa analysis for reliability. Results: Five-hundred-sixty-seven patients were enrolled; 30 were excluded. The resulting of 537 patients was 55% female and had a median age of 46 years. Seven of them were triage level-1 (1.3%), 142 of them were level-2 (26.4%), 167 of them were level-3 (31.1%), 166 of them were level-4 (30.9%) and 55 of them were level-5 (10.3%). Weighted kappa for triage assignment was found as 0.825. Resource use, hospitalization rates, mean length of stay and 48h mortality were found as strongly associated with triage level. Over-triage rate was 15.5%, under-triage rate was 3.7% and the sensitivity and specificity of the triage system were calculated 99.3% and 96%. Conclusions: Dokuz Eylul Triage System is a reliable and validated five-category triage algorithm for Turkey to be implanted into clinical practice of a tertiary emergency department. We report that Dokuz Eylul Triage System could be able to detect and sieve the patients safely who need resuscitation and emergent care.