Validity of the Canadian Paediatric Triage and Acuity Scale in a tertiary care hospital

Abstract

Objective: We evaluated the validity of the Canadian Paediatric Triage and Acuity Scale (PaedCTAS) for children visiting a pediatric emergency department (ED).

Methods: This was a retrospective study evaluating all children who presented to a pediatric university-affiliated ED during a 1-year period. Data were retrieved from the ED database. Information regarding triage and disposition was registered in an ED database by a clerk following patient management. In the absence of a gold standard for triage, admission to hospital, admission to pediatric intensive care unit (PICU) and length of stay (LOS) in the ED were used as surrogate markers of severity. The primary outcome measure was the correlation between triage level (from 1 to 5) and admission to hospital. The correlation between triage level and dichotomous outcomes was evaluated by a chi2 test and an analysis of variance (ANOVA) was used to evaluate the association between triage level and ED LOS.

Results: Over the 1-year period, 58,529 patients were triaged in the ED. The proportion admitted to hospital was 63% for resuscitation (level 1), 37% for emergent (level 2), 14% for urgent (level 3), 2% for semiurgent (level 4) and 1% for nonurgent (level 5) (p < 0.001). There was also a good correlation between triage levels and LOS and admission to PICU (both p < 0.001).

Conclusion: This computerized version of PaedCTAS demonstrates a string association with admission to hospital, admission to PICU and LOS in the ED. These results suggest that PaedCTAS is a valid tool for triage of children in a pediatric ED.