[Accuracy of emergency severity index of triage in Imam Hossein hospital - Tehran, Iran [2011]]

ABSTRACT

Triage is the most important and the first stage of patient's management at the time of arrival to hospital emergency department. Emergency severity index [ESI] is a common triage system worldwide. This study was aimed to evaluate the accuracy of ESI in emergency department of Imam Hossein hospital in Tehran, Iran. In this descriptive study the result of patients' triage based on ESI were gathered for all patients referred to emergency department of Imam Hossein Hospital from January to April 2011. A questioner was filled for each patient by the nurse and a emergency specialist independently. The lamda index was applied to compare the nurse observation with the specialist clinician. The STATA-11.0 statistical software and roctab table were used to determine the validity, specificity and sensivity of triage. Data were analyzed using Chi-Square and Fisher tests. The calculated lamda for the degree of agreement of triage between nurse and clinician was 81% [95% CI 0.79-0.83]. The sensivity of triage for step I, II, III, IV and V were 100%, 53.2%, 90.7%, 67.1% and 98% respectively. The specificity of triage for step I, II, III, IV and V were 99.8%, 97.5%, 93.7%, 98.3% and 94% respectively. There was a significant overlapping between the triage step and the patient clinical outcome. This study showed that five steps triage contain a high accuracy and estimation of patient outcomes: