Validity of the Japan Acuity and Triage Scale in adults: a cohort study

Kuriyama, Akira; Ikegami, Tetsunori; Kaihara, Toshie; Fukuoka, Toshio; Nakayama, Takeo

doi:10.1136/emermed-2017-207214

Cited by 22 publications

(13 citation statements)

References 27 publications

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“…In this study, the triage system demonstrated good predictive ability for in-hospital mortality, ICU admission and general ward admission prediction (AUC = 0.838, 0.830, 0.792 respectively). Similar results were shown in the validation studies of other triage systems [2,24]. A retrospective study to This study showed that the higher the urgency triage categories of patients, the greater their risk of hospitalization and progression to death.…”

Section: Discussionsupporting

confidence: 84%

“…It is a global reality that emergency departments are overcrowded. In order to prioritize timely treatment for patients who present to emergency departments, triage scales have been implemented [1][2][3][4][5]. Hence, triage plays an important role in emergency medical care.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have shown that triage levels were related to certain patient outcome variables, such as hospital admission, ICU admission and in-hospital mortality [2,[13][14][15]. Level 1, level 2 and level 3 are defined as urgent patients with a higher proportion of serious adverse events, such as hospital admission and mortality, compared with level 4, which is defined as non-urgent patients [13,16].…”

Section: Introductionmentioning

confidence: 99%

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Prognostic value of a four-level Chinese emergency triage for an Emergency Department: A prospective cohort study

Huang¹,

Xie

Xiong³

et al. 2019

Preprint

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Background In order to assign treatment priorities of patients who presenting to emergency departments (ED), various triage scales have been developed around the world. In china, four-tier triage scale was recommended by a national triage guideline that published by the central Chinese government. After that a four-tier triage system, used only in tertiary hospitals in Shenzhen, was published by the Public Hospital Administration of Shenzhen Municipalitfy in August, 2013 (Shenzhen Triage System, SZTS). But the ability in predicting admission and in-hospital mortality with the four-level triage scale for patients presented in emergency department was unclear. This research aimed to assess the prognostic value of the SZTS by examining the association between triage levels and clinical outcomes in adult patients.Methods Patients 18 years of age or older, who were triaged category 1, 2 or 3 in the emergency department (ED) from May 17, 2017 until September 27, 2017, were enrolled. This study evaluated an association between triage level and in-hospital mortality, ICU admission and general ward admission by using multivariable logistic regression analysis. Receiver operating characteristic curves were used to assess the predictive ability of SZTS in determining in-hospital mortality, ICU admission and general ward admission.Results There were 383 patients enrolled in the study. More urgent triage level were significantly related to a higher proportion of in-hospital mortality, ICU admission and general ward admission. The OR for in-hospital mortality (OR 11.6, 95% CI 5.8-22.9, p<0.001), ICU admission (OR 14.4, 95% CI 7.4-27.7, p<0.001) and general ward admission (OR 10.6, 95% CI 1.4-79.2, p=0.022) were greater at triage level 1 compared to triage level 2 and level 3. The AUC for in-hospital mortality, ICU admission and general ward admission prediction of SZTS was 0.838, 0.830 and 0.792, respectively.Conclusions This study suggests that triage levels were associated with general ward admission, ICU admission and in-hospital mortality, and SZTS showed good performance for clinical outcomes prediction.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic value of a four-level Chinese emergency triage for an Emergency Department: A prospective cohort study

Huang¹,

Xie

Xiong³

et al. 2019

Preprint

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“…Some studies in Japan have confirmed the usefulness of EWS in hospital and triage settings. [19][20][21][22] However, several countries require nationwide in-hospital EWS implementation, and in the UK, this has been widely used in prehospital settings, outpatients and emergency services. 4 Paramedics in Japan should directly request the hospital for ambulance acceptance on the scene.…”

Section: Open Accessmentioning

confidence: 99%

Efficacy of prehospital National Early Warning Score to predict outpatient disposition at an emergency department of a Japanese tertiary hospital: a retrospective study

et al. 2020

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ObjectivesThe National Early Warning Score (NEWS) was originally developed to assess hospitalised patients in the UK. We examined whether the NEWS could be applied to patients transported by ambulance in Japan.DesignThis retrospective study assessed patients and calculated the NEWS from paramedic records. Emergency department (ED) disposition data were categorised into the following groups: discharged from the ED, admitted to the ward, admitted to the intensive care unit (ICU) or died in the ED. The predictive performance of NEWS for patient disposition was assessed using receiver operating characteristic curve analysis. Patient dispositions were compared among NEWS-based categories after adjusting for age, sex and presence of traumatic injury.SettingA tertiary hospital in Japan.ParticipantsOverall, 2847 patients transported by ambulance between April 2017 and March 2018 were included.ResultsThe mean (±SD) NEWS differed significantly among patients discharged from the ED (n=1330, 3.7±2.9), admitted to the ward (n=1263, 60.3±3.8), admitted to the ICU (n=232, 9.4±4.0) and died in the ED (n=22, 110.7±2.9) (p<0.001). The prehospital NEWS C-statistics (95% CI) for admission to the ward, admission to the ICU or death in the ED; admission to the ICU or death in the ED; and death in the ED were 0.73 (0.72–0.75), 0.81 (0.78–0.83) and 0.90 (0.87–0.93), respectively. After adjusting for age, sex and trauma, the OR (95% CI) of admission to the ICU or death in the ED for the high-risk (NEWS ≥7) and medium-risk (NEWS 5–6) categories was 13.8 (8.9–21.6) and 4.2 (2.5–7.1), respectively.ConclusionThe findings from this Japanese tertiary hospital setting showed that prehospital NEWS could be used to identify patients at a risk of adverse outcomes. NEWS stratification was strongly correlated with patient disposition.

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“…With great interest we have read the publication in the Emergency Medicine Journal from Kuriyama et al entitled ‘Validity of the Japan Acuity and Triage Scale (JTAS) in adults: a cohort study’ 1. We bring your attention to a few points that may enhance understanding of the validity of JTAS.…”

mentioning

confidence: 99%

Japan Triage and Acuity Scale needs to revise level 5 criteria

Mirhaghi

Ebrahimi

2018

Emerg Med J

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Validity of the Japan Acuity and Triage Scale in adults: a cohort study

Abstract: Our study suggests an association of JTAS acuity with overall admission, ICU admission and ED length of stay, thereby demonstrating the predictive validity of JTAS.

Cited by 22 publications

References 27 publications

Prognostic value of a four-level Chinese emergency triage for an Emergency Department: A prospective cohort study

Prognostic value of a four-level Chinese emergency triage for an Emergency Department: A prospective cohort study

Efficacy of prehospital National Early Warning Score to predict outpatient disposition at an emergency department of a Japanese tertiary hospital: a retrospective study

Japan Triage and Acuity Scale needs to revise level 5 criteria

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