uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Emergency department triage scales and their components: a systematic review of the scientific evidence
Show others and affiliations
2011 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, Vol. 19, 42- p.Article in journal (Refereed) Published
Abstract [en]

Emergency department (ED) triage is used to identify patients' level of urgency and treat them based on their triage level. The global advancement of triage scales in the past two decades has generated considerable research on the validity and reliability of these scales. This systematic review aims to investigate the scientific evidence for published ED triage scales. The following questions are addressed:

1. Does assessment of individual vital signs or chief complaints affect mortality during the hospital stay or within 30 days after arrival at the ED?

2. What is the level of agreement between clinicians' triage decisions compared to each other or to a gold standard for each scale (reliability)?

3. How valid is each triage scale in predicting hospitalization and hospital mortality?

A systematic search of the international literature published from 1966 through March 31, 2009 explored the British Nursing Index, Business Source Premier, CINAHL, Cochrane Library, EMBASE, and PubMed. Inclusion was limited to controlled studies of adult patients (≥ 15 years) visiting EDs for somatic reasons. Outcome variables were death in ED or hospital and need for hospitalization (validity). Methodological quality and clinical relevance of each study were rated as high, medium, or low. The results from the studies that met the inclusion criteria and quality standards were synthesized applying the internationally developed GRADE system. Each conclusion was then assessed as having strong, moderately strong, limited, or insufficient scientific evidence. If studies were not available, this was also noted.

We found ED triage scales to be supported, at best, by limited and often insufficient evidence.

The ability of the individual vital signs included in the different scales to predict outcome is seldom, if at all, studied in the ED setting. The scientific evidence to assess interrater agreement (reliability) was limited for one triage scale and insufficient or lacking for all other scales. Two of the scales yielded limited scientific evidence, and one scale yielded insufficient evidence, on which to assess the risk of early death or hospitalization in patients assigned to the two lowest triage levels on a 5-level scale (validity).

Place, publisher, year, edition, pages
2011. Vol. 19, 42- p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-169446DOI: 10.1186/1757-7241-19-42PubMedID: 21718476OAI: oai:DiVA.org:uu-169446DiVA: diva2:506752
Available from: 2012-02-29 Created: 2012-02-29 Last updated: 2012-04-12Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed
In the same journal
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 187 hits
ReferencesLink to record
Permanent link

Direct link