Comparison with in-hospital Korean Triage and Acuity Scale (KTAS) and prehospital triage system in a metropolitan city

OBJECTIVE: This study was conducted to analyze and compare the classifications of a prehospital triage system and an in-hospital triage system. METHODS: The records of patients transferred from the ‘119’ emergency service for 5 months (from January 1 to May 31, 2016) were collected and records of first aid activities were assessed. We examined cases classified as four (urgent, semi-urgent, potentially urgent, and non-urgent) of five stages, excluding death. In the hospital, data were collected from medical records and classifications made using the five Korean Triage and Acuity Scale (KTAS) stages (1, resuscitation; 2, emergency; 3, urgent; 4, less urgent; and 5, non-urgent) were analyzed. RESULTS: The number of patients enrolled in the study was 3,457. Of them, 2,301 were discharged after treatment and 1,156 were hospitalized. According to the prehospital triage classification, 726 of the 3,457 cases were urgent, 593 were semiurgent, 1,944 were potentially urgent, and 194 were non-urgent. The results of the in-hospital triage were as follows: 114 KTAS 1 (3.3%), 491 KTAS 2 (14.2%), 1,345 KTAS 3 (38.9%), 1,227 KTAS 4 (35.5%), and 280 KTAS 5 (8.1%). The odds ratio trend for hospitalization showed a larger decrease according to in-hospital staging (95% CI, 0.32–0.39) than according to prehospital staging (95% CI, 0.50–0.60). The odds ratio trend for intensive care unit (ICU) admission also showed a larger decrease according to in-hospital staging (95% CI, 0.16–0.22) than according to prehospital staging (95% CI, 0.37–0.48). CONCLUSION: We found little correspondence in classifications made according to the KTAS and prehospital triage systems. However, the tendencies toward decreases in the hospitalization and ICU admission rates were similar.

Time-course changes in the expression levels of miR-122, -155, and -21 as markers of liver cell damage, inflammation, and regeneration in acetaminophen-induced liver injury in rats

Drug-induced liver injury (DILI) is a significant threat to patient health and a major concern during drug development. Recently, multiple circulating microRNAs (miRNAs) have been reported to be potential biomarkers for DILI. To adapt and validate miRNAs for clinical use, we investigated the time-course changes in miR-122 expression levels in an acetaminophen-induced liver injury model in rats. In addition, miR-155 and miR-21 were evaluated as makers of inflammation and regeneration, respectively, to characterize liver status. Our results revealed that miR-122 is an early and sensitive biomarker of hepatocellular injury at a stage when alanine transaminase, aspartate transaminase, and total bilirubin were not detectable. However, no significant differences in the expression levels of other miRNAs (miR-155 and -21) were observed between treatment and vehicle groups. Collectively, these time-course changes in the expression levels of miRNAs may be useful as markers for clinical decision-making, in the diagnosis and treatment of DILI.