Accuracy of Emergency Department Triage Using Emergency Severity Index for Predicting Patient Outcome in Chumphae hospital
Keywords:
triage , emergency severity index, patient outcomeAbstract
Background : Emergency severity index (ESI) is increasingly used in emergency department triage globally. Despite its widespread adoption and numerous strengths includings ease of use and linkage to anticipated emergency department resource utilization, ESI still has several limitations. It relies heavily on each provider judgment, yielding a significant scoring variation.
Objectives : To evaluate the accuracy of the five-level triage system using ESI and determine the relationship of the triage level with patient outcomes.
Methods : A cross-sectional study was performed at the emergency department of Chumphae Hospital during 1 July 2021 – 30 September 2021. The patient’s characteristic data were analyzed using percentage, median and interquartile range. The agreement between different level of triage determined by nurse/paramedic and emergency physician was evaluated by using Kappa weight index (K).
Results : Accuracy of emergency department triage determined by the agreement between nurse/paramedic and emergency physician was in a moderate agreement (Kappa weight index at 0.552, Agreement 625.1%, p-value <.001) and there was a significant relationship between the triage level and the outcome of patient, moderate agreement in admit group (Kappa 0.503) and discharge group (Kappa 0.430) and good agreement in refer group (Kappa 0.769).
Conclusions : Emergency department triage using ESI by Nurse/Paramedic provide moderate accuracy and moderate to good accuracy in estimation of the patient outcomes.
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