Evidence map›Paper›PMID 41286624›Full record

ArticleBMC emergency medicine2025

Comparative evaluation of the Manchester Triage System and emergency severity index in predicting critical events in the emergency department.

Anna Ingielewicz, Marzena Szarafińska, Petra M Grešner, Piotr Rychlik, Maciej Zając, Szymon Bielicki, Tomasz Stolarewicz, Mariusz Siemiński

Abstract readComparative Study
In one paragraph

Article in BMC emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
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

8 authors.

Anna IngielewiczDepartment of Emergency Medicine, Faculty of Health Science, Medical University of Gdańsk, Gdańsk, Poland. anna.ingielewicz@gumed.edu.pl.
Marzena SzarafińskaDepartment of Emergency Medicine, Faculty of Health Science, Medical University of Gdańsk, Gdańsk, Poland.
Petra M GrešnerCentre of Biostatistics and Bioinformatics Analyses, Medical University of Gdańsk, Gdańsk, Poland.
Piotr RychlikEmergency Department, Copernicus Hospital, Gdańsk, Poland.
Maciej ZającEmergency Department, Copernicus Hospital, Gdańsk, Poland.
Szymon BielickiEmergency Department, Pomeranian Hospitals, Wejherowo, Poland.
Tomasz StolarewiczEmergency Department, Pomeranian Hospitals, Wejherowo, Poland.
Mariusz SiemińskiDepartment of Emergency Medicine, Faculty of Health Science, Medical University of Gdańsk, Gdańsk, Poland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGiven the increasing number of patients presenting to Emergency Departments (EDs), the use of effective and reliable triage tools is essential. Such systems enable rapid assessment of the urgency of medical intervention, which contributes to improved workflow, optimized resource allocation, and potentially better clinical outcomes. This study presents a direct comparison of two of the most widely used triage systems globally: the Manchester Triage System (MTS) and the Emergency Severity Index (ESI), evaluating their classification agreement and predictive value for critical events in the ED population.

methodsThis retrospective study included 1,072 patients who were concurrently assessed using both systems during a transitional six-month period in which both MTS and ESI were applied in parallel at the study hospital. The correlation between triage categories assigned by each system was analyzed, as well as their association with predefined critical events.

resultsA moderate level of classification agreement was observed between the two systems (Cohen's kappa = 0.51; Spearman's rho = 0.49). ESI assigned over 80% of patients to priority level 3, whereas MTS distributed patients more evenly between levels 3 and 4. Both systems demonstrated a statistically significant association between higher acuity levels and an increased risk of critical events-lower category numbers (i.e., higher priority) corresponded with a greater likelihood of severe complications.

conclusionsThe results confirm the effectiveness of both triage systems in assessing patients' clinical condition while highlighting important differences in their classification structures. These findings may inform the choice of triage system in clinical practice and underscore the need for further research on optimization and potential integration with artificial intelligence-based decision support tools.

Indexed as

Emergency Service, HospitalSeverity of Illness IndexTriageAdultAgedFemaleHumansMaleMiddle AgedPredictive Value of TestsRetrospective StudiesClinical outcomeEmergency Severity IndexManchester Triage SystemRisk stratificationTriage accuracyTriage agreement

Identifiers

PMID41286624
PMCPMC12751399

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LicenceCC BY-NC-ND
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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.