Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

The Copenhagen Triage Algorithm is non-inferior to a traditional triage algorithm: A cluster-randomized study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Kinetics of the soluble urokinase plasminogen activator receptor (suPAR) in cirrhosis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Incidence, prevalence and risk factors for hepatitis C in Danish prisons

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Polygenic predisposition to breast cancer and the risk of coronary artery disease

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Cardiovascular Manifestations of Systemic Sclerosis: A Danish Nationwide Cohort Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Clinical implications of electrocardiographic bundle branch block in primary care

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

INTRODUCTION: Triage systems with limited room for clinical judgment are used by emergency departments (EDs) worldwide. The Copenhagen Triage Algorithm (CTA) is a simplified triage system with a clinical assessment.

METHODS: The trial was a non-inferiority, two-center cluster-randomized crossover study where CTA was compared to a local adaptation of Adaptive Process Triage (ADAPT). CTA involves initial categorization based on vital signs with a final modification based on clinical assessment by an ED nurse. We used 30-day mortality with a non-inferiority margin at 0.5%. Predictive performance was compared using Receiver Operator Characteristics.

RESULTS: We included 45,347 patient visits, 23,158 (51%) and 22,189 (49%) were triaged with CTA and ADAPT respectively with a 30-day mortality of 3.42% and 3.43% (P = 0.996) a difference of 0.01% (95% CI: -0.34 to 0.33), which met the non-inferiority criteria. Mortality at 48 hours was 0.62% vs. 0.71%, (P = 0.26) and 6.38% vs. 6.61%, (P = 0.32) at 90 days for CTA and ADAPT. CTA triaged at significantly lower urgency level (P<0.001) and was superior in predicting 30-day mortality, Area under the curve: 0.67 (95% CI 0.65-0.69) compared to 0.64 for ADAPT (95% CI 0.62-0.66) (P = 0.03). There were no significant differences in rate of admission to the intensive care unit, length of stay, waiting time nor rate of readmission within 30 or 90 days.

CONCLUSION: A novel triage system based on vital signs and a clinical assessment by an ED nurse was non-inferior to a traditional triage algorithm by short term mortality, and superior in predicting 30-day mortality.

TRIAL REGISTRATION: Clinicaltrials.gov NCT02698319.

OriginalsprogEngelsk
TidsskriftPLoS One
Vol/bind14
Udgave nummer2
Sider (fra-til)e0211769
ISSN1932-6203
DOI
StatusUdgivet - 2019

ID: 56745331