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Associations of the Emergency Severity Index triage categories with patients' vital signs at triage: a prospective observational study
  1. Ineke van der Wulp1,
  2. Hebe A A Rullmann1,
  3. Luke P H Leenen2,
  4. Henk F van Stel1
  1. 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
  2. 2Trauma Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
  1. Correspondence to Dr Henk van Stel, Julius Center for Health Sciences and Primary Care, STR6.131, PO box 85500, 3508 GA Utrecht, The Netherlands; h.vanstel{at}umcutrecht.nl

Abstract

Study objective Previous studies on the construct validity of the Emergency Severity Index (ESI) were focused on outcome measures which could not be obtained directly at triage. A study was conducted to the construct validity of the ESI by measuring the association between the ESI triage categories and patients' vital signs at triage.

Methods A prospective observational study was conducted at an emergency department (ED) in the Netherlands. All patients who entered the ED between 20 July 2009 and 21 August 2009 were eligible for inclusion in the study. Patients' vital signs, triage category, age, gender, referrer and main complaint were registered. Vital signs were scored according to the Worthing Physiological Scoring System (WPSS) and the numerical pain rating scale. The data were analysed using ordinal logistic regression analyses.

Results An association was found between ESI triage categories and patients' vital signs at triage. Patients in WPSS categories ‘urgent’ and ‘alert’ were more likely triaged into the urgent triage categories (ESI triage categories 1 and 2) than patients with normal WPSS scores. However, no associations were found between pain scores and ESI triage categories.

Conclusion This study supports the validity of the ESI as it showed that patients' vital signs are associated with the ESI triage categories. However, a revision of the ESI guidelines concerning pain assessments is necessary.

  • Triage
  • reproducibility of results
  • health status indicators
  • emergency care systems
  • emergency care systems
  • emergency departments

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Footnotes

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the medical ethics committee of the University Medical Center Utrecht.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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