Validation of the modified Japanese Triage and Acuity Scale-based triage system emphasizing the physiologic variables or mechanism of injuries.
Validation of the modified Japanese Triage and Acuity Scale-based triage system emphasizing the physiologic variables or mechanism of injuries.
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DOI：
10.1186/s12245-015-0097-9
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发表时间：
2016-12
影响因子：
3.2
通讯作者：
Ikusaka M
中科院分区：
文献类型：
--
作者：
Funakoshi H;Shiga T;Homma Y;Nakashima Y;Takahashi J;Kamura H;Ikusaka M
加拿大分诊和敏锐度量表是一个有效的分诊系统。该系统从2012年开始在日本急诊科（ED）进行翻译和实施。该系统被命名为日本分诊和敏锐度量表（Japan Triage and Acuity Scale）；然而，日本分诊和敏锐度量表的验证研究有限。此外，对于有多项投诉的患者来说，由于只需要单一投诉，这可能会变得具有挑战性。因此，我们假设使用一阶修正而没有主诉检测的日本分诊和敏锐度量表的修改版本是准确的。一项回顾性队列研究评估了日本医院急诊科所有成年患者的改良分诊量表水平与结果之间的相关性。根据总入院率（包括住院、急诊科死亡）和分诊级别之间的住院时间的比较，评估了修改后的分诊量表水平的构建有效性。 17,121例病例中分诊量表五个级别（1级最紧急）的分布如下：1:451、2:1148、3:7703、4:7652和5:167。每个级别的总录取率分别为 1:89.8、2:68.2、3:26.4、4:6.6 和 5:0.6%，从 5 级到 1 级逐渐增加，且显着（p< 0.01）。与 3 级患者相比，1、2、4 和 5 级患者的总入院率分别为 14.4、5.1、0.27 和 0.030。除了 1 级患者外，级别越紧急的患者住院时间越长。日本分诊和视力量表的修改版是总入院率和住院时间的有效预测因子，可以使护士在不发生任何症状的情况下对患者进行分流。查明主要投诉。
The Canadian Triage and Acuity Scale is a valid triage system. The system was translated and implemented in the Japanese emergency departments (EDs) from 2012. This system was named the Japanese Triage and Acuity Scale; however, the validation studies of the Japanese Triage and Acuity Scale have been limited. In addition, for a patient with multiple complaints, it could become challenging, due to its requirement of a single complaint. Therefore, we hypothesized that a modified version of the Japanese Triage and Acuity Scale using first-order modifiers without chief complaint detection is accurate. A retrospective cohort study evaluated a correlation between the modified triage scale level and outcomes of all adult emergency department patients at a Japanese hospital. Construct validity of the modified triage scale level was assessed based on comparisons of total admission rate (including hospitalizations, emergency department deaths) and length of stay between triage levels. The distributions of five levels of the triage scale (level 1 is the most urgent) among the 17,121 cases are as follows: 1:451, 2:1148, 3:7703, 4:7652, and 5:167. Total admission rates by each level were 1:89.8, 2:68.2, 3:26.4, 4:6.6, and 5:0.6 %, which progressively increased from level 5 to 1 and were significant (p < 0.01). Compared with patients in level 3, the odds of total admission rates were 14.4, 5.1, 0.27, and 0.030 for the patients in levels 1, 2, 4, and 5. The length of stay was longer in the patients with the more urgent levels except for those with level 1. The modified version of the Japanese Triage and Acuity Scale is a valid predictor of total admission and length of stay and may enable the nurses to triage patients without detecting the chief complaints.