Validity of the Korean triage and acuity scale in older patients compared to the adult group

Chung, Ho Sub; Namgung, Myeong; Lee, Dong Hoon; Choi, Yoon Hee; Bae, Sung Jin

doi:10.1016/j.exger.2023.112136

Cited by 10 publications

(8 citation statements)

References 33 publications

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“…8, 15,22 Furthermore, the non-cancer group in our study presented a higher triage level than the cancer group, which is consistent with patients ages 65 and over having a higher severity level than younger patients in the emergency department in the previous studies. 23,24 As our ndings demonstrate, higher severity is associated with increased resuscitation intervention utility. Even with less severity, our ndings demonstrate that patients with cancer had a statistically signi cant higher one-year mortality rate than the non-cancer group (35.0% and 18.7%, respectively).…”

Section: Discussionmentioning

confidence: 64%

Comparison of Resuscitation Intervention Utilization in the Emergency Department by Palliative Care Eligible Patients Between Cancer and Non-Cancer

Wibulpolprasert,

Wangviboonchai,

Saengprateeptong

et al. 2024

Preprint

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Background Resuscitation interventions are procedures for managing clinical deterioration in patients with life-threatening conditions by securing the airway, maintaining breathing, or supporting circulation. Little is known about differences in the use of resuscitation interventions and the characteristics of patients eligible for palliative care in the emergency department. The objectives of this study are to compare resuscitation interventions in the emergency department between patients with cancer and non-cancer palliative care eligibility. Methods A retrospective cohort study was conducted by reviewing the medical records of the palliative care eligible patients who visited the emergency department of one university hospital between January and June 2019. Results Among the 956 visits (13.7%) by palliative care eligible patients of 7000 random visits, 480 were patients with cancer (50.2%), and 476 were non-cancer patients (49.8%). The overall median age was 72, and 54.1% were female. The mortality rates in the following year were 35.0% for patients with cancer and 18.7% for non-cancer illnesses. The patients with cancer and non-cancer received prior palliative care at 7.3% and 0.8% (p <0.001) and initiated palliative care at the emergency department at 6.3% and 2.7%, respectively (p = 0.008). The non-cancer patients utilized overall resuscitation interventions 1.7 times more than the cancer patients (aOR = 1.7, 95% CI = 1.0–2.6, p = 0.030). Conclusion For the palliative care eligible patients in the emergency department, patients with cancer and non-cancer significantly differed in their characteristics. Patients with non-cancer received more resuscitation interventions than patients with cancer.

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Section: Discussionmentioning

confidence: 64%

Comparison of Resuscitation Intervention Utilization in the Emergency Department by Palliative Care Eligible Patients Between Cancer and Non-Cancer

Wibulpolprasert,

Wangviboonchai,

Saengprateeptong

et al. 2024

Preprint

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“…If the patients were in a life-threatening condition and required immediate medical care, they were classified as KTAS Level 1 and immediately admitted to the ED. Patients who did not meet Level 1 criteria were classified from Levels 2 to 5 based on their chief complaint and other variables [ 3 ]. The KTAS level obtained was recorded in the EMR and transmitted to NEDIS.…”

Section: Methodsmentioning

confidence: 99%

“…However, it lacks consideration for older patients, resulting in the classification of healthy young adults and older patients under the same criteria. A previous study indicated poor association between the KTAS and severity in older patients (aged >65 years) compared to adults, with a higher up-triage rate observed in the older patient group [ 3 ]. Similarly, the Japan Triage and Acuity Scale, developed based on the CTAS, demonstrated lower performance in predicting hospitalization for older patients compared to adults [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Validation of the Korean Version of the Clinical Frailty Scale-Adjusted Korean Triage and Acuity Scale for Older Patients in the Emergency Department

Chung,

Choi,

Lim

et al. 2024

Medicina

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Background and Objectives: The Clinical Frailty Scale (CFS), used to screen for prehospital frailty in patients aged >65 years, is simple, time-efficient, and has been validated in emergency departments (EDs). In this study, we analyzed whether the Korean Triage and Acuity Scale (KTAS) classification by level in older patients determined to have frailty based on the Korean version of the CFS increases the triage performance of the current KTAS. Materials and Methods: The primary outcome was 30-day in-hospital mortality, and secondary outcomes were hospital and intensive care unit (ICU) admissions. This study retrospectively analyzed prospectively collected data from three ED centers. Patients with a CFS score ranging from five (mildly frail) to nine (terminally ill) were categorized into the frailty group. We upgraded the KTAS classification of the frailty group by one level of urgency and defined this as the CFS-KTAS. Results: The cutoff values for predicting admission were three and two for the KTAS and CFS-KTAS, respectively. A significant difference was observed in the area under the receiver operating characteristic (AUROC) curve between the KTAS and CFS-KTAS. To predict ICU admission, the cutoff score was two for both scales. A significant difference was observed in the AUROC curve between the KTAS and CFS-KTAS. For predicting in-hospital mortality, the cutoff score was two for both scales. A significant difference was observed in the AUROC curve between the KTAS and CFS-KTAS. Conclusions: This study showed that the CFS-adjusted KTAS has a more useful prognostic value than the KTAS alone for predicting hospital outcomes in older patients.

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“…Two types of rapid RT‐PCR assays were available for these patients: Xpert and STANDARD M10. The Xpert assay was used only for patients with a more severe clinical status according to the Korean Triage and Acuity Scale (KTAS) classification 7 . This was because daily supply of Xpert reagents to each emergency department was managed by Korean government owing to a shortage of imported reagents.…”

Section: Methodsmentioning

confidence: 99%

Clinical performance of the STANDARD M10 SARS‐CoV‐2 rapid RT‐PCR assay in patients visiting an emergency department

Lee,

Han,

Ryu

et al. 2023

Journal of Medical Virology

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In emergency departments, rapid screening of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) was important for arranging limited isolation resources and patient care during the coronavirus disease 2019 (COVID‐19) pandemic. STANDARD M10 SARS‐CoV‐2 (SD Biosensor) is a recently developed cartridge‐based RT‐PCR that provides a turnaround time of 1 h, which is shorter than that for conventional RT‐PCR. This study evaluated the clinical performance of STANDARD M10 in patients visiting an emergency department. From March to June 2022, two specimens were collected from patients visiting an emergency department. Each specimen comprised one nasopharyngeal and one oropharyngeal swab. Respective specimens underwent rapid RT‐PCR using STANDARD M10 and conventional RT‐PCR using Allplex SARS‐CoV‐2 (Seegene). When discordant results occurred, specimens undergoing the STANDARD M10 were retested with the Allplex to exclude specimen variations. Retest results replaced initial results of the Allplex. Clinical performance of STANDARD M10 was compared with Allplex. The study enrolled 1971 patients. COVID‐19 prevalence was 6.2% based on the Allplex. Compared with the Allplex, overall agreement, positive percent agreement, and negative percent agreement of STANDARD M10 were 99.5% (95% CI: 99.1%–99.8%), 95.9% (95% CI: 90.8%–98.3%), and 99.8% (95% CI: 99.4%–99.9%), respectively. Nine discordant results were all positive on droplet digital PCR, except for one specimen that was positive with STANDARD M10. The STANDARD M10 showed reliable diagnostic performance for detecting SARS‐CoV‐2 from patients visiting in emergency departments and is a useful tool in emergency healthcare systems because of its easy‐to‐use cartridge‐based assay and short resulting time for detecting SARS‐CoV‐2.

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Validity of the Korean triage and acuity scale in older patients compared to the adult group

Cited by 10 publications

References 33 publications

Comparison of Resuscitation Intervention Utilization in the Emergency Department by Palliative Care Eligible Patients Between Cancer and Non-Cancer

Comparison of Resuscitation Intervention Utilization in the Emergency Department by Palliative Care Eligible Patients Between Cancer and Non-Cancer

Validation of the Korean Version of the Clinical Frailty Scale-Adjusted Korean Triage and Acuity Scale for Older Patients in the Emergency Department

Clinical performance of the STANDARD M10 SARS‐CoV‐2 rapid RT‐PCR assay in patients visiting an emergency department

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