masterThesis
Desempeño del Emergency Severity Index como herramienta de Triage en la Fundación Santa Fe de Bogotá en el año 2018
Autor
Castrillón López, Daniel Mauricio
Lewis Ramos, Álvaro Andrés
Espinosa Moya, Beatriz Fernanda
Vargas Gallo, Juan Pablo
Institución
Resumen
Background: Triage is a system used in the emergency department to classify patients promptly and prioritize those who require immediate attention to offer them a better outcome and avoid delays in care. Worldwide, the most widely used triage systems are composed of 5 levels of complexity. their processes have been standardized to the point of establishing decision-making algorithms. Although there is descriptive literature on the different Triage scales, there is no data that establishes the operational performance of these systems, therefore, it is not clear which one is the most accurate when it comes to demonstrating better clinical results. Objective: To evaluate the operational performance of the Triage - Emergency Severity Index (ESI) scale used in the Fundación Santa Fe de Bogotá when comparing it against the clinical outcomes of the patients, resources used, and final diagnoses. Methods: A diagnostic test study was carried out where the operational performance of the ESI Triage scale was evaluated by evaluating the medical records of those adult males and female patients who were admitted to the emergency service of the Fundación Santa Fe de Bogotá in the year 2018. Results: A sample of 400 patients was analyzed, of which 0% triage 1, 4.5% triage 2, 35.5% triage 3, 52.5% triage 4, and 7.5% triage 5. The percentage of sub-triage for triage 2 is 0 % and over-triage 16.67%, for triage 3 the under-triage was 4.23% and over-triage 11.97%, for triage 4 the under-triage was 37.8% and the over-triage was 25.36, and for triage 5 the under-triage was 29.03 % and 0% overtriage. The weighted percentage of agreement was 85.67% and the weighted kappa coefficient was 49.28%. Conclusions: The concordance of the Emergency Severity Index with the clinical outcome in the adult population in our institution in 2018 had a moderately acceptable performance, which can be explained by the experience in the use of the triage tool and the high-quality institutional standards.