Validity Analysis of Korean Triage and Acuity Scale

한국형 응급환자 분류도구(Korean Triage and Acuity Scale) 타당도 분석

  • Lee, Inhye (Department of Emergency Medicine, Hanyang University College of Medicine) ;
  • Kim, Ohhyun (Yonsei University Wonju College of Medicine) ;
  • Kim, Changsun (Department of Emergency Medicine, Hanyang University College of Medicine) ;
  • Oh, Jaehoon (Department of Emergency Medicine, Hanyang University College of Medicine) ;
  • Lim, Taeho (Department of Emergency Medicine, Hanyang University College of Medicine) ;
  • Lee, Jinwoong (Chungnam University College of Medicine) ;
  • Cho, Suck Ju (Pusan University College of Medicine) ;
  • Hwang, Seong Youn (Sungkyunkwan University College of Medicine) ;
  • Park, Joonbum (Soonchunhyang University College of Medicine)
  • 이인혜 (한양대학교 의과대학 응급의학교실) ;
  • 김오현 (연세대학교 원주의과대학 응급의학교실) ;
  • 김창선 (한양대학교 의과대학 응급의학교실) ;
  • 오재훈 (한양대학교 의과대학 응급의학교실) ;
  • 임태호 (한양대학교 의과대학 응급의학교실) ;
  • 이진웅 (충남대학교 의과대학 응급의학교실) ;
  • 조석주 (부산대학교 의과대학 응급의학교실) ;
  • 황성연 (성균관대학교 의과대학 응급의학교실) ;
  • 박준범 (순천향대학교 의과대학 응급의학교실)
  • Received : 2017.07.31
  • Accepted : 2017.10.27
  • Published : 2018.02.28

Abstract

Purpose: The Korean Triage and Acuity Scale (KTAS), which was developed in 2012 due to the need for a single triage tool for emergency patients in Korea, has since become nationalized. Although five years has passed, there has been limited evidence of its validation. Therefore, this study was conducted to analyze the validity of the new triage system. Methods: We conducted a multicenter prospective study. Data were collected from seven hospitals and 42,187 patients were classified using the KTAS from April 1, 2013 to July 6, 2014. We analyzed whether the indirect severity variables showed meaningful differences according to KTAS levels. The variables consisted of disposition from emergency room, length of stay, numbers of consultations, examination of computed tomography, emergency room costs, and performance of emergent interventions. Results: From KTAS level 1 to 5, a decreasing trend in the length of stay in emergency room, frequency of consultation with other departments, admission, computed tomography rate, emergency intervention rate, and emergency room costs was observed. Upon binominal logistic regression, disposition from emergency room and emergent intervention rate showed the highest odds ratio with statistical significance. Conclusion: The results of this study demonstrated that KTAS is a valid emergency triage tool that reflects the severity of the patient with indirect indicators. The results of this study will be useful as a reference for quality control of KTAS.

Keywords

Acknowledgement

Supported by : 보건복지부, 순천향대학교

References

  1. Radjou AN, Mahajan P, Baliga DK. Where do I go? a trauma victim's plea in an informal trauma system. J Emerg Trauma Shock. 2013;6:164-70. https://doi.org/10.4103/0974-2700.115324
  2. Leibovici D, Gofrit ON, Heruti RJ, Shapira SC, Shemer J, Stein M. Interhospital patient transfer: a quality improvement indicator for prehospital triage in mass casualties. Am J Emerg Med. 1997;15:341-4. https://doi.org/10.1016/S0735-6757(97)90120-0
  3. Kristiansen T, Lossius HM, Soreide K, Steen PA, Gaarder C, Næss PA. Patients referred to a norwegian trauma centre: effect of transfer distance on injury patterns, use of resources and outcomes. J Trauma Manag Outcomes. 2011;5:9. https://doi.org/10.1186/1752-2897-5-9
  4. Min SS, Kim JK, Lee G, Park CW, Yang HJ, Ryoo E, et al. Evaluation of pertinence in prehospital triage and management by paramedic's reports. J Korean Soc Emerg Med. 2000;11:489-98.
  5. Wuerz RC, Meador SA. Effects of prehospital medications on mortality and length of stay in congestive heart failure. Ann Emerg Med. 1992;21:669-74. https://doi.org/10.1016/S0196-0644(05)82777-5
  6. Richardson JD, Franklin G, Santos A, Harbrecht B, Danzl D, Coleman R, et al. Effective triage can ameliorate the deleterious effects of delayed transfer of trauma patients from the emergency department to the ICU. J Am Coll Surg. 2009;208:671-81. https://doi.org/10.1016/j.jamcollsurg.2008.11.018
  7. Park JB, Choi HJ, Kang BS, Kim CS, Kang HG, Lim TH. A nationwide survey of Korean emergency department triage systems and scales: a first step towards reform of the emergency medical service system. J Korean Soc Emerg Med. 2014;25:499-508.
  8. Lee JY, Oh SH, Peck EH, Lee JM, Park KN, Kim SH, et al. The validity of the Canadian triage and acuity scale in predicting resource utilization and the need for immediate life saving interventions in elderly emergency department patients. Scand J Trauma Resusc Emerg Med. 2011;19:68. https://doi.org/10.1186/1757-7241-19-68
  9. Gilboy N, Tanabe P, Travers DA. The emergency severity index version 4: changes to ESI level 1 and pediatric fever criteria. J Emerg Nurs. 2005;31:357-62. https://doi.org/10.1016/j.jen.2005.05.011
  10. Park JB. A doctoral thesis: assessment of paying subject of emergency management charge in two stage triage after application of Korean Triage and Acuity Scale. Chuncheon: Kangwon National University; 2014. p.24-6.
  11. Kim JH, Kim JW, Kim SY, Hong DY, Park SO, Baek KJ, et al. Validation of the Korean Triage and Acuity Scale compare to triage by emergency severity index for emergency adult patient: preliminary study in a tertiary hospital emergency medical center. J Korean Soc Emerg Med. 2016;27:436-41.
  12. National Emergency Medical Center. 2015 Annual report of Korean emergency medicine. Seoul: National Emergency Medical Center press; 2015. p.122.
  13. National Fire Agency. Report: quality control analysis of 119 emergency medical service. 2015;132.
  14. Wuerz RC, Milne LW, Eitel DR, Travers D, Gilboy N. Reliability and validity of a new five level triage instrument. Acad Emerg Med. 2000;7:236-42. https://doi.org/10.1111/j.1553-2712.2000.tb01066.x
  15. Lemeshow S, Le Gall JR. Modeling the severity of illness of ICU patients: a systems update. JAMA. 1994;272:1049-55. https://doi.org/10.1001/jama.1994.03520130087038