응급 환자 중증도 분류의 전산화 = Computerized Triage System in the Emergency Department

다국어 초록 (Multilingual Abstract)

Purpose: The existing triage systems for trauma at prehospital field sites have limitations when applied to various non-traumatic conditions at hospitals and show disagreement in inter-or intra-rater assessments. The purpose of study was to develop a simple and objective triage tool which could be applied to both traumatic and non-traumatic patients and would reduce the rate of disagreement in inter-or intra-rater assessments by using a computerized system.
Methods: A prospective study was designed to evaluate the characteristics and the outcomes of patients who visited Korea University Emergency Medical Center between April 1 and May 31, 2002. The observed parameters were age, sex, AVPU scale, mode of visit, and vital signs including blood pressure, pulse rate, respiratory rate, and body temperature. The patient s outcome, which reflected the severity of condition, was expressed on the basis of progress, including home discharge, admission to general ward, and admission to intensive care unit (ICU) or death.
Results: Of the 3,242 patients enrolled in the study, 724 were traumatic patients, and 2518 were non-traumatic patients. The accuracy rate between the actual and the calculated classification of a patient' s outcome for all patients was 66.2% for discharge, 64.1% for admission to general ward, 30.6% for admission to ICU or death. The corresponding numbers for non-traumatic patients were 70.3%, 70.6%, 32.1%, and those for traumatic patients were 61.3%, 52.5%, 29.8%.
Conclusion: The Computerized Triage System provides a useful guideline to classify patients into two groups (discharge vs admission), especially in non-traumatic conditions, but it has limitations for classifying into critically ill patents.