Standard

Comparing complaint-based triage scales and early warning scores for emergency department triage. / Schinkel, Michiel; Bergsma, Lyfke; Veldhuis, Lars Ingmar; Ridderikhof, Milan L.; Holleman, Frits.

In: Emergency medicine journal, Vol. 39, No. 9, 01.09.2022, p. 691-696.

Research output: Contribution to journalArticleAcademicpeer-review

Harvard

APA

Vancouver

Author

Schinkel, Michiel ; Bergsma, Lyfke ; Veldhuis, Lars Ingmar ; Ridderikhof, Milan L. ; Holleman, Frits. / Comparing complaint-based triage scales and early warning scores for emergency department triage. In: Emergency medicine journal. 2022 ; Vol. 39, No. 9. pp. 691-696.

BibTeX

@article{5ce1b6a11fce41189d1e356422bccc4c,
title = "Comparing complaint-based triage scales and early warning scores for emergency department triage",
abstract = "Background: Emergency triage systems are used globally to prioritise care based on patients' needs. These systems are commonly based on patient complaints, while the need for timely interventions on regular hospital wards is usually assessed with early warning scores (EWS). We aim to directly compare the ability of currently used triage scales and EWS scores to recognise patients in need of urgent care in the ED. Methods: We performed a retrospective, single-centre study on all patients who presented to the ED of a Dutch Level 1 trauma centre, between 1 September 2018 and 24 June 2020 and for whom a Netherlands Triage System (NTS) score as well as a Modified Early Warning Score (MEWS) was recorded. The performance of these scores was assessed using surrogate markers for true urgency and presented using bar charts, cross tables and a paired area under the curve (AUC). Results: We identified 12 317 unique patient visits where NTS and MEWS scores were documented during triage. A paired comparison of the AUC of these scores showed that the MEWS score had a significantly better AUC than the NTS for predicting the need for hospital admission (0.65 vs 0.60; p<0.001) or 30-day all-cause mortality (0.70 vs 0.60; p<0.001). Furthermore, when non-urgent MEWS scores co-occur with urgent NTS scores, the MEWS score seems to more accurately capture the urgency level that is warranted. Conclusions: The results of this study suggest that EWSs could potentially be used to replace the current emergency triage systems.",
keywords = "emergency department, triage",
author = "Michiel Schinkel and Lyfke Bergsma and Veldhuis, {Lars Ingmar} and Ridderikhof, {Milan L.} and Frits Holleman",
note = "Publisher Copyright: {\textcopyright} ",
year = "2022",
month = sep,
day = "1",
doi = "10.1136/emermed-2021-211544",
language = "English",
volume = "39",
pages = "691--696",
journal = "Emergency medicine journal",
issn = "1472-0205",
publisher = "BMJ Publishing Group",
number = "9",

}

RIS

TY - JOUR

T1 - Comparing complaint-based triage scales and early warning scores for emergency department triage

AU - Schinkel, Michiel

AU - Bergsma, Lyfke

AU - Veldhuis, Lars Ingmar

AU - Ridderikhof, Milan L.

AU - Holleman, Frits

N1 - Publisher Copyright: ©

PY - 2022/9/1

Y1 - 2022/9/1

N2 - Background: Emergency triage systems are used globally to prioritise care based on patients' needs. These systems are commonly based on patient complaints, while the need for timely interventions on regular hospital wards is usually assessed with early warning scores (EWS). We aim to directly compare the ability of currently used triage scales and EWS scores to recognise patients in need of urgent care in the ED. Methods: We performed a retrospective, single-centre study on all patients who presented to the ED of a Dutch Level 1 trauma centre, between 1 September 2018 and 24 June 2020 and for whom a Netherlands Triage System (NTS) score as well as a Modified Early Warning Score (MEWS) was recorded. The performance of these scores was assessed using surrogate markers for true urgency and presented using bar charts, cross tables and a paired area under the curve (AUC). Results: We identified 12 317 unique patient visits where NTS and MEWS scores were documented during triage. A paired comparison of the AUC of these scores showed that the MEWS score had a significantly better AUC than the NTS for predicting the need for hospital admission (0.65 vs 0.60; p<0.001) or 30-day all-cause mortality (0.70 vs 0.60; p<0.001). Furthermore, when non-urgent MEWS scores co-occur with urgent NTS scores, the MEWS score seems to more accurately capture the urgency level that is warranted. Conclusions: The results of this study suggest that EWSs could potentially be used to replace the current emergency triage systems.

AB - Background: Emergency triage systems are used globally to prioritise care based on patients' needs. These systems are commonly based on patient complaints, while the need for timely interventions on regular hospital wards is usually assessed with early warning scores (EWS). We aim to directly compare the ability of currently used triage scales and EWS scores to recognise patients in need of urgent care in the ED. Methods: We performed a retrospective, single-centre study on all patients who presented to the ED of a Dutch Level 1 trauma centre, between 1 September 2018 and 24 June 2020 and for whom a Netherlands Triage System (NTS) score as well as a Modified Early Warning Score (MEWS) was recorded. The performance of these scores was assessed using surrogate markers for true urgency and presented using bar charts, cross tables and a paired area under the curve (AUC). Results: We identified 12 317 unique patient visits where NTS and MEWS scores were documented during triage. A paired comparison of the AUC of these scores showed that the MEWS score had a significantly better AUC than the NTS for predicting the need for hospital admission (0.65 vs 0.60; p<0.001) or 30-day all-cause mortality (0.70 vs 0.60; p<0.001). Furthermore, when non-urgent MEWS scores co-occur with urgent NTS scores, the MEWS score seems to more accurately capture the urgency level that is warranted. Conclusions: The results of this study suggest that EWSs could potentially be used to replace the current emergency triage systems.

KW - emergency department

KW - triage

UR - http://www.scopus.com/inward/record.url?scp=85128895891&partnerID=8YFLogxK

U2 - 10.1136/emermed-2021-211544

DO - 10.1136/emermed-2021-211544

M3 - Article

C2 - 35418407

VL - 39

SP - 691

EP - 696

JO - Emergency medicine journal

JF - Emergency medicine journal

SN - 1472-0205

IS - 9

ER -

ID: 23351622