Conclusionsĭespite rigorous and ongoing training of ESI users, a large number of patients in this cohort were under- or over-triaged. A number of factors identifiable at time of presentation including advanced age, bradycardia, tachycardia, hypoxia, hyperthermia, and several specific chief complaints (i.e., neurologic complaints, chest pain, shortness of breath) were identified as independent predictors of under-triage, while other chief complaints (i.e., hypertension and allergic complaints) were independent predictors of over-triage. Under-triage was associated with a significantly higher rate of admission and critical outcome, while over-triage was associated with a lower rate of both. Initial ESI-determined triage score was classified as inaccurate for 16,426 of 96,071 patient encounters. Independent predictors of under- and over-triage were identified by multivariate logistic regression. Chi-square analysis was used to validate this surrogate gold standard, via comparison of associations with disposition and clinical outcomes.
#MID SOUTH SYNERGY ESI NUMBER FULL#
The accuracy of initial ESI score assignment was determined by comparison with a score entered at the close of each ED encounter by treating physicians with full knowledge of actual resource utilization, disposition, and acute outcomes. This was a single-center retrospective cohort study. Here, we sought to measure the frequency of under- and over-triage of patients by nurses using the Emergency Severity Index (ESI) in Brazil and to identify factors independently associated with each. Triage errors create opportunity for increased morbidity and mortality. Emergency department (ED) triage is performed to prioritize care for patients with critical and time-sensitive illness.
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