Evidence map›Paper›PMID 35428351›Full record

ArticleScandinavian journal of trauma, resuscitation and emergency medicine2022

A longitudinal, retrospective registry-based validation study of RETTS©, the Swedish adult ED context version.

Sara C Wireklint, Carina Elmqvist, Bengt Fridlund, Katarina E Göransson

Open access · goldAbstract read
In one paragraph

Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Frequent users of the ambulance service in a Swedish region: a retrospective cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026
    Article
  3. Article
  4. Observational
  5. Observational
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Sara C WireklintEmergency Department, Region Kronoberg, Växjö, Sweden. sara.wireklint@kronoberg.se.ORCID http://orcid.org/0000-0002-8123-0283
Carina ElmqvistDepartment of Research and Development, Region Kronoberg, Sigfridsvägen 5, 352 57, Växjö, Sweden.
Bengt FridlundCentre of Interprofessional Collaboration Within Emergency Care (CICE), Linnaeus University, Växjö, Sweden.
Katarina E GöranssonCaring Sciences, School of Health and Welfare, Dalarna University, Falun, Sweden.
Linnaeus University · SEDalarna University · SE

Funding

Medical Research Council of Southeast Sweden (FORSS) FORSS-646221
6 · The paper itself

Abstract

backgroundTriage and triage related work has been performed in Swedish Emergency Departments (EDs) since the mid-1990s. The Rapid Emergency Triage and Treatment System (RETTS©), with annual updates, is the most applied triage system. However, the national implementation has been performed despite low scientific foundation for triage as a method, mainly related to the absence of adjustment to age and gender. Furthermore, there is a lack of studies of RETTS© in Swedish ED context, especially of RETTS© validity. Hence, the aim the study was to determine the validity of RETTS©.

methodsA longitudinal retrospective register study based on cohort data from a healthcare region comprising two EDs in southern Sweden. Two editions of RETTS© was selected; year 2013 and 2016, enabling comparison of crude data, and adjusted for age-combined Charlson comorbidity index (ACCI) and gender. All patients ≥ 18 years visiting either of the two EDs seeing a physician, was included. Primary outcome was ten-day mortality, secondary outcome was admission to Intensive Care Unit (ICU). The data was analysed with descriptive, and inferential statistics.

resultsTotally 74,845 patients were included. There was an increase in patients allocated red or orange triage levels (unstable) between the years, but a decrease of admission, both to general ward and ICU. Of all patients, 1031 (1.4%) died within ten-days. Both cohorts demonstrated a statistically significant difference between the triage levels, i.e. a higher risk for ten-day mortality and ICU admission for patients in all triage levels compared to those in green triage level. Furthermore, significant statistically differences were demonstrated for ICU admission, crude as well as adjusted, and for adjusted data ten-day mortality, indicating that ACCI explained ten-day mortality, but not ICU admission. However, no statistically significant difference was found for the two annual editions of RETTS© considering ten-day mortality, crude data.

conclusionThe annual upgrade of RETTS© had no statistically significant impact on the validity of the triage system, considering the risk for ten-day mortality. However, the inclusion of ACCI, or at least age, can improve the validity of the triage system.

Indexed as

Emergency Service, HospitalTriageAdultHumansRegistriesRetrospective StudiesSwedenEmergency Department—Emergency Service, HospitalRapid emergency triage and treatment system—RETTS©SwedenTriage—emergency medical servicesValidity—reproducibility of results

Identifiers

PMID35428351
PMCPMC9013139
OpenAlexW4224055974

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.