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.
ABSTRACT
PURPOSE: Many patients who are acutely poisoned with organophosphorus pesticides have co-ingested alcohol. The purpose of this study was to identify the factors that influence mortality in organophosphate intoxication and the differences between alcohol coingested patients and non-coingested patients, looking at vital signs, length of admission, cholinesterase activity, complications, and mortality. METHODS: All patients visiting one Emergency Department (ED) with organophosphate intoxication between January 2000 and December 2012 were reviewed retrospectively. The patients were divided into two groups, alcohol coingested group and non-coingested group. RESULTS: During the study period, 136 patients (alcohol coingested group, 95 patients; non-coingested group, 41 patients) presented to the ED with organophosphate intoxication. Seventy-one alcohol coingested patients (74.1%) vs. 16 non-coingested patients (39.0%) received endotracheal intubation, with results of the analysis showing a clear distinction between the two groups (p=0.001). Twenty-three alcohol coingested patients (24.2%) vs. 1 non-coingested patient (2.4%) required inotropics, indicating a significant gap (p=0.002). Twenty-eight alcohol coingested patients (29.5%) vs. 2 non-coingested patients (4.9%) died, with results of the analysis showing a clear distinction between the two groups (p=0.002). CONCLUSION: In cases of organophosphate intoxication, alcohol coingested patients tended to receive endotracheal intubation, went into shock, developed central nervous system complications, and more died.