Observational studyEmergency medicine journal : EMJ2015
Identification of the severe sepsis patient at triage: a prospective analysis of the Australasian Triage Scale.
Observational study in Emergency medicine journal : EMJ, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Automated sepsis prediction from unstructured electronic health records using natural language processing: a retrospective cohort study.BMJ health & care informatics · 2025Article
- Caregiver alignment with triage acuity levels and drivers for discrepancy between caregiver assessment and triage acuity levels: a cross-sectional questionnaire based study.BMC health services research · 2025Article
- Diagnosis of sepsis in the emergency department: a real-world analysis from Lombardy, Italy.Internal and emergency medicine · 2024Article
- Audit of a computerized version of the Manchester triage system and a SIRS-based system for the detection of sepsis at triage in the emergency department.International journal of emergency medicine · 2022Article
- The Presentation, Pace, and Profile of Infection and Sepsis Patients Hospitalized Through the Emergency Department: An Exploratory Analysis.Critical care explorations · 2021Article
- Usefulness of ischemia-modified albumin in the diagnosis of sepsis/septic shock in the emergency department.Clinical and experimental emergency medicine · 2020Article
- National Early Warning Score (NEWS) as Prognostic Triage Tool for Septic Patients.Infection and drug resistance · 2020Article
- How to close the maternal and neonatal sepsis gap in sub-Saharan Africa.BMJ global health · 2020Article
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Authors and funding
4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aims to investigate the accuracy and validity of the Australasian Triage Scale (ATS) as a tool to identify and manage in a timely manner the deteriorating patient with severe sepsis.
methodsThis was a prospective observational study conducted in five sites of adult patients. Keywords and physiological vital signs data from triage documentation were analysed for the 'identified' status compared with confirmed diagnosis of severe sepsis after admission to the intensive care unit. The primary outcome is the accuracy and validity of the ATS Triage scale categories to identify a prespecified severe sepsis population at triage. Secondary outcome measures included time compliance, antimicrobial administration and mortality prediction. Statistical analysis included parameters of diagnostic performance. Adjusted multivariate logistic regression analysis was applied to mortality prediction.
resultsOf 1022 patients meeting the criteria for severe sepsis, 995 were triaged through the emergency department, 164 with shock. Only 53% (n=534) were identified at triage. The overall sensitivity of the ATS to identify severe sepsis was 71%. ATS 3 was the most accurate (likelihood ratio positive, 2.45, positive predictive value 0.73) and ATS 2 the most valid (area under the curve 0.567) category. Identified cases were more likely to survive (OR 0.81, 95% CI 0.697 to 0.94, p<0.007). The strongest bias-adjusted predictors of mortality were circulatory compromise variable (1.78, 95% CI 1.34 to 1.41, p<0.001), lactate >4 (OR 1.63, 95% CI 1.10 to 2.89, p<0.001) and ATS 1 category (OR 1.55, 95% CI 1.09 to 2.35, p<0.005).
conclusionsThe ATS and its categories is a sensitive and moderately accurate and valid tool for identifying severe sepsis in a predetermined group, but lacks clinical efficacy and safety without further education or quality improvement strategies targeted to the identification of severe sepsis.
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