Re-evaluation characteristics of the Korean Triage and Acuity Scale (KTAS): the relationship between overcrowding and KTAS re-evaluation

ABSTRACT

Objective@#The purpose of the study was to analyze triage re-evaluation characteristics of the Korean Triage and Acuity Scale (KTAS). In particular, the relationship between overcrowding and KTAS re-evaluation at the emergency department (ED) was analyzed. @*Methods@#In this study, a retrospective chart review of 3,158 KTAS re-evaluation cases was performed. The sample included patients visiting a regional ED from January 1 to December 31 in 2018. Crowding was measured using the ED occupancy rate. Any cases assigned to a higher level on initial rather than the final evaluation were defined as overtriage, while any cases assigned to a lower level on initial rather than the final evaluation were defined as under-triage. @*Results@#The ED occupancy rate, which represents the level of ED overcrowding, scored 1.24±0.45 in case of undertriage, and 1.36±0.51 in case of over-triage. KTAS re-evaluation did not vary significantly based on the ED occupancy rate. The treatment results were analyzed according to the different KTAS grades of the KTAS re-evaluation group. The treatment results were different depending on the degree of under-triage. In the under-triage group, patients with a KTAS 2 or 3-grade difference had higher rates of ED hospitalization, mortality, and inter-hospital transfer than the patients with a KTAS 1 grade difference, and this variation was significant. @*Conclusion@#KTAS re-evaluation was not related to overcrowding in the ED. Among the KTAS re-evaluation cases, under-triage patients had higher rates of ED hospitalization, mortality, and hospital transfer. The triage provider, therefore, needs to be more careful at the time of initial classification.