MEDICAL EMERGENCY TRIAGE AND TREATMENT SYSTEM (METTS): A NEW PROTOCOL IN PRIMARY TRIAGE AND SECONDARY PRIORITY DECISION IN EMERGENCY MEDICINE
MEDICAL EMERGENCY TRIAGE AND TREATMENT SYSTEM (METTS): A NEW PROTOCOL IN PRIMARY TRIAGE AND SECONDARY PRIORITY DECISION IN EMERGENCY MEDICINE
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DOI：
10.1016/j.jemermed.2008.04.003
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发表时间：
2011-06-01
影响因子：
1.5
通讯作者：
Jourak, Majid
中科院分区：
文献类型：
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作者：
Widgren, Bengt R.;Jourak, Majid
背景：在许多急诊科 (ED) 分诊评分系统中，生命体征并未作为评估参数。目的：评估新的急诊医学方案在大量转入院内护理的患者中的有效性。方法：2006年1月1日至6月30日期间，萨尔格伦斯卡大学医院急诊科收治了22,934名患者。其中，8695 人被转介至医院接受护理并纳入研究。使用了一种新的五级分类工具，在分类决策中结合了生命体征、症状和体征。还在 132 项平行、单盲观察中对评估者间的分歧进行了小规模控制。结果：50% 的患者通过救护车入院，另外 50% 通过预约入院。与未经预约的患者（6.2 +/- 10 天）相比，救护车入院患者的住院时间（9.3 +/- 14 天）显着延长（p < 0.001）。救护车收治的患者的院内死亡率（8.1%）高于预约患者（2.4%）。住院时间和院内死亡率随着优先级别的提高而增加。在最高优先级组中，32-53% 的患者在初级治疗后降级至较低优先级。结论：在本研究中，METTS 方案被证明是一种可靠的分诊方法，也是对急诊室患者进行二次重新评估的敏感工具。 (C) 2011 爱思唯尔公司
Background: In many Emergency Department (ED) triage scoring systems, vital signs are not included as an assessment parameter. Objectives: To evaluate the validity of a new protocol for Emergency Medicine in a large cohort of patients referred to in-hospital care. Methods: From January 1 to June 30, 2006, 22,934 patients were admitted to the ED at Sahlgrenska University Hospital. Of those, 8695 were referred to in-hospital care and included in the study. A new five-level triage tool, combining vital signs, symptoms, and signs in the triage decision, was used. A small control of the inter-rater disagreement was also performed in 132 parallel, single-blinded observations. Results: Fifty percent of the patients were admitted by ambulance and the other 50% by walk-in. Hospital stay was significantly (p < 0.001) longer in those admitted by ambulance (9.3 +/- 14 days) as compared with walk-in patients (6.2 +/- 10 days). In-hospital mortality incidence was higher (8.1%) in patients admitted by ambulance, as compared with walk-in patients (2.4%). Hospital stay and in-hospital mortality increased with higher level of priority. In the highest priority groups, 32-53% of the patients were downgraded to a lower priority level after primary treatment. Conclusion: In the present study, the METTS protocol was shown to be a reliable triage method and a sensitive tool for secondary re-evaluation of the patient in the ED. (C) 2011 Elsevier Inc.