Öz

Objectives: Triage aims to determine the clinical priority of patients based on their presenting features. Scoring systems-including physiological parameters-to predict mortality have been described, but in most triage methods used in emergency departments, vital signs or laboratory parameters are not included as standard assessments. The objective of this study was to measure agreement and acuity on the urgency of an emergency department patient between the points of views of healthcare professionals. We also sought to determine which vital signs and parameters affect triage decision by creating several mods with different parameters.

Materials and Methods: This prospective study was carried out on 550 patients referred to an academic emergency department. The patients triage levels were determined by nurses, intern doctors, residents and emergency physicians. Eleven mods were defined with several components, for each mod 50 patients were selected. To evaluate the agreement between raters triage decisions, the chance-adjusted measure of agreement kappa was calculated.

Results: Of the 550 patients included in the study, agreement for nurses was 0.374, kappa value between interns and physician was 0.257, and a value of 0.311 was found for residents.

Conclusion: In emergency medicine, there is a strong need for sensitive tools to identify and characterize patients at admission to the emergency department. According to our results, the most important parameters affecting triage decision were found to be oxygen saturation and Glasgow Coma scale