Evidence map›Paper›PMID 35590239›Full record

ArticleBMC emergency medicine2022

Using mobility status as a frailty indicator to improve the accuracy of a computerised five-level triage system among older patients in the emergency department.

Cheng-Yu Chien, Chung-Hsien Chaou, Chung-Cheng Yeh, Kuang-Hung Hsu, Shi-Ying Gao, Chip-Jin Ng

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC emergency medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.1field-weighted citation impact, top 15% 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

8 citing papers in PubMed, 16 citations in OpenAlex.

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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

6 authors at 4 institutions in 1 country.

Cheng-Yu ChienDepartment of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, No. 5 Fushing St., Gueishan Dist, Taoyuan City, 333, Taiwan.
Chung-Hsien ChaouDepartment of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, No. 5 Fushing St., Gueishan Dist, Taoyuan City, 333, Taiwan.
Chung-Cheng YehDepartment of Emergency Medicine, Chang Gung Memorial Hospital, Keelung Branch, Keelung, 204, Taiwan.
Kuang-Hung HsuDepartment of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, No. 5 Fushing St., Gueishan Dist, Taoyuan City, 333, Taiwan.
Shi-Ying GaoDepartment of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, 333, Taiwan.
Chip-Jin NgDepartment of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, No. 5 Fushing St., Gueishan Dist, Taoyuan City, 333, Taiwan. ngowl@ms3.hinet.net.
Linkou Chang Gung Memorial Hospital · TWChang Gung Memorial Hospital · TWChang Gung University of Science and Technology · TWKeelung Chang Gung Memorial Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOwing to societal ageing, the number of older individuals visiting emergency departments (EDs) has increased in recent years. For this patient population, accurate triage systems are required. This retrospective cohort study assessed the accuracy of a computerised five-level triage system, the Taiwan Triage and Acuity System (TTAS), by determining its ability to predict in-hospital mortality in older adult patients and compare it with the corresponding rate in younger adult patients presenting to EDs. The association between frailty, which the current triage system does not consider, was also investigated.

methodsThe medical records of adult patients admitted to a single ED between 2016 and 2017 were reviewed. Data collected included information on demographics, triage level, frailty status, in-hospital mortality, and medical resource utilisation. The patients were divided into four age groups: two older adult groups (older: 65-84 years and very old: ≥85 years) and two younger adult groups (young: 18-39 and middle-aged: 40-64 years).

resultsOur study included 265,219 ED adult patients, of whom 64,104 and 16,009 were in the older and very old groups, respectively. The in-hospital mortality rate at each triage level increased with age. The ability of the TTAS to predict in-hospital mortality decreased with age (area under the receiver operating characteristic curve [AUROC]: young: 0.86; middle-aged, 0.84; and older and very old: 0.79). Frailty was associated with in-hospital mortality (odds ratio, 2.20; 95% confidence interval, 2.03-2.38). Adding mobility status as a frailty indicator to TTAS only slightly improved its ability to predict in-hospital mortality (AUROC: 0.74-0.77) in patients ≥65 years of age.

conclusionsThe ability of the current triage system to predict in-hospital mortality decreases with age. Although frailty as mobility was associated with in-hospital mortality, its addition to the TTAS only slightly improved the accuracy with which in-hospital mortality in older patients presenting to EDs was predicted.

Indexed as

FrailtyTriageAgedAged, 80 and overEmergency Service, HospitalHospital MortalityHumansMiddle AgedRetrospective StudiesEmergency departmentFrailtyOlder patientsTriage acuity scale

Identifiers

PMID35590239
PMCPMC9118587
OpenAlexW4280490780

What OpenQuestion holds

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LicenceCC BY
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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.