Yonsei Med J.  2022 Mar;63(3):272-281. 10.3349/ymj.2022.63.3.272.

Development and Validation of Simple Age-Adjusted Objectified Korean Triage and Acuity Scale for Adult Patients Visiting the Emergency Department

Affiliations
  • 1Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  • 2Department of Emergency Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
  • 3Department of Emergency Medicine, Pohang St. Mary’s Hospital, Pohang, Korea
  • 4Department of Emergency Medical Services, Kyungdong University, Wonju, Korea
  • 5Department of Emergency Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
  • 6Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea

Abstract

Purpose
The study aimed to develop an objectified Korean Triage and Acuity Scale (OTAS) that can objectively and quickly classify severity, as well as a simple age-adjusted OTAS (S-OTAS) that reflects age and evaluate its usefulness.
Materials and Methods
A retrospective analysis was performed of all adult patients who had visited the emergency department at three teaching hospitals. Sex, systolic blood pressure, diastolic blood pressure, pulse rate, respiratory rate, body temperature, O 2 saturation, and consciousness level were collected from medical records. The OTAS was developed with objective criterion and minimal OTAS level, and S-OTAS was developed by adding the age variable. For usefulness evaluation, the 30-day mortality, the rates of computed tomography scan and emergency procedures were compared between Korean Triage and Acuity Scale (KTAS) and OTAS.
Results
A total of 44402 patients were analyzed. For 30-day mortality, S-OTAS showed a higher area under the curve (AUC) compared to KTAS (0.751 vs. 0.812 for KTAS and S-OTAS, respectively, p<0.001). Regarding the rates of emergency procedures, AUC was significantly higher in S-OTAS, compared to KTAS (0.807 vs. 0.830, for KTAS and S-OTAS, respectively, p=0.013).
Conclusion
S-OTAS showed comparative usefulness for adult patients visiting the emergency department as a triage tool compared to KTAS.

Keyword

Triage; emergency medical services; mortality
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