ArticleInternational journal of emergency medicine2018
Accuracy of emergency department triage using the Emergency Severity Index and independent predictors of under-triage and over-triage in Brazil: a retrospective cohort analysis.
Article in International journal of emergency medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05230108 (Implementation of Advanced Triage in the Emergency Department of Bellvitge University Hospital), which is not on this map. Cited by 63 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Implementation of Advanced Triage in the Emergency Department of Bellvitge University Hospital
Who cites it
63 citing papers in PubMed, 2 syntheses or guidelines pooled it, 163 citations in OpenAlex.
- Improving triage performance in emergency departments using machine learning and natural language processing: a systematic review.BMC emergency medicine · 2024Pooled it
- ["Triage"-primary assessment of patients in the emergency department : An overview with a systematic review].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020Pooled it
- Accuracy and Disparities in Pediatric Emergency Triage: A Multicenter Retrospective Cohort Study.Hospital pediatrics · 2026Article
- Clinical Urgency of After-Hours Presentations of Dogs and Cats to a Private Small-Animal Practice in Germany: A Retrospective Study of 4579 Visits.Veterinary sciences · 2026Article
- From Promising Capabilities to Pervasive Bias: Assessing Large Language Models for Emergency Department Triage.Journal of healthcare informatics research · 2026Article
- Reducing Mis-triage in Emergency Departments (RemEDy): Protocol for Improving Triage Accuracy Through Real-time Evaluation and Artificial Intelligence.JMIR research protocols · 2026Article
- A multi-national observational study on the concordance between the translational triage tool and routine prehospital triage.Scientific reports · 2026Observational
- Improving the Accuracy of ED Triage Using the Australasian Triage Scale: A Closed-Loop Quality Improvement Project.Cureus · 2026Article
- Factors associated with under-triage and emergency department length of stay in non-traumatic acute abdominal pain: a multicenter retrospective analysis in China.International journal of emergency medicine · 2026Article
- Multi-Evidence Clinical Reasoning With Retrieval-Augmented Generation for Emergency Triage: Retrospective Evaluation Study.JMIR medical informatics · 2026Article
- Should we leave paediatric emergency triage to artificial intelligence? A comparison of ChatGPT 4o and Grok 3.Frontiers in pediatrics · 2026Article
- The Impact of Pain on Triage Accuracy, Hospital Admission, and Length of Stay in Patients Presenting to the Emergency Department: A Systematic Review.Archives of academic emergency medicine · 2026Review
- [Primary assessment of urological emergencies using the example of a specialist hospital].Urologie (Heidelberg, Germany) · 2026Article
- Predicting triage levels in patients presenting with cardiac-related symptoms: a comparison of supervised machine learning methods.BMC emergency medicine · 2025Article
- From prediction to action: a retrospective observational study on the real-world implementation of Critical Interventions (CrIs), an AI-based clinical decision support system changing clinical behavior in the emergency department.BMC medical informatics and decision making · 2025Observational
- Article
- Emergency Department Utilization and Patient Acuity in the Setting of Care-Seeking Hesitancy: Insights from the COVID-19 Pandemic.The western journal of emergency medicine · 2025Article
- Emergency Department Triage Accuracy and Delays in Care for High-Risk Conditions.JAMA network open · 2025Article
- Activity, triage levels and impact of the pandemic on hospital emergency departments: A multicentre cross-sectional study.Journal of advanced nursing · 2025Observational
- Early identification of high-risk patients admitted to emergency departments using vital signs and machine learning.World journal of emergency medicine · 2025Article
3 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundEmergency department (ED) triage is performed to prioritize care for patients with critical and time-sensitive illness. Triage errors create opportunity for increased morbidity and mortality. Here, we sought to measure the frequency of under- and over-triage of patients by nurses using the Emergency Severity Index (ESI) in Brazil and to identify factors independently associated with each.
methodsThis was a single-center retrospective cohort study. The accuracy of initial ESI score assignment was determined by comparison with a score entered at the close of each ED encounter by treating physicians with full knowledge of actual resource utilization, disposition, and acute outcomes. Chi-square analysis was used to validate this surrogate gold standard, via comparison of associations with disposition and clinical outcomes. Independent predictors of under- and over-triage were identified by multivariate logistic regression.
resultsInitial ESI-determined triage score was classified as inaccurate for 16,426 of 96,071 patient encounters. Under-triage was associated with a significantly higher rate of admission and critical outcome, while over-triage was associated with a lower rate of both. A number of factors identifiable at time of presentation including advanced age, bradycardia, tachycardia, hypoxia, hyperthermia, and several specific chief complaints (i.e., neurologic complaints, chest pain, shortness of breath) were identified as independent predictors of under-triage, while other chief complaints (i.e., hypertension and allergic complaints) were independent predictors of over-triage.
conclusionsDespite rigorous and ongoing training of ESI users, a large number of patients in this cohort were under- or over-triaged. Advanced age, vital sign derangements, and specific chief complaints-all subject to limited guidance by the ESI algorithm-were particularly under-appreciated.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.