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. 2011 Nov 3:19:68.
doi: 10.1186/1757-7241-19-68.

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

Ju Young Lee  1 , Sang Hoon Oh, Eun Hee Peck, Jung Min Lee, Kyu Nam Park, Soo Hyun Kim, Chun Song Youn
Affiliations

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

Ju Young Lee et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Background: We evaluated the validity of the Canadian Triage and Acuity Scale (CTAS) in elderly emergency department (ED) patients. In particular, we examined the sensitivity and specificity of the CTAS for identifying elderly patients who received an immediate life-saving intervention in the ED.

Methods: We reviewed the medical records of consecutive patients who were 65 years of age or older and presented to a single academic ED within a three-month period. The CTAS triage scores were compared to actual patient course, including disposition, discharge outcome and resource utilization. We calculated the sensitivity and specificity of the CTAS triage for identifying patients who received an immediate intervention.

Results: Of the 1903 consecutive patients who were ≥ 65 years of age, 113 (5.9%) had a CTAS level of 1, 174 (9.1%) had a CTAS level of 2, 1154 (60.6%) had a CTAS level of 3, 347 (18.2%) had a CTAS level of 4, and 115 (6.0%) had a CTAS level of 5. As a patient's triage score increased, the severity (such as mortality and intensive care unit admission) and resource utilization increased significantly. Ninety-four of the patients received a life-saving intervention within an hour following their arrival to the ED. The CTAS scores for these patients were 1, 2 and 3 for 46, 46 and 2 patients, respectively. The sensitivity and specificity of a CTAS score of ≤ 2 for identifying patients for receiving an immediate intervention were 97.9% and 89.2%, respectively.

Conclusions: The CTAS is a triage tool with high validity for elderly patients, and it is an especially useful tool for categorizing severity and for recognizing elderly patients who require immediate life-saving intervention.

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Figures

Figure 1
Figure 1
Template for transferred cardiac arrest patients from other facility. DOA: Death on arrival.
Figure 2
Figure 2
Distribution of Canadian Triage and Acuity Scale (CTAS) score in patients who were ≥ 65 years of age and patients who were < 65 years of age.
Figure 3
Figure 3
Odds ratio for consultation, CT scan and admission by Canadian Triage and Acuity Scale (CTAS) score. Each plot represents the odds ratio and 95% confidence interval compared with CTAS 3.
Figure 4
Figure 4
Box and whisker plot of hospital cost by Canadian Triage and Acuity Scale (CTAS) score. Bars represent median, boxes represent the interquartile range, and whiskers extend to 5th and 95th percentiles.
See this image and copyright information in PMC

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