title: An observational study of patients triaged in category 5 of the Emergency Severity Index.
abstract: OBJECTIVE
  Patients triaged in category 5 of the Emergency Severity Index (ESI) do not need any resources before discharge from the emergency department (ED). We studied the characteristics of these patients and focused on those who were admitted or sent to the outpatient department after their ED visit.
  
  
  METHODS
  A retrospective observational study was conducted on 117 740 patient presentations. Patients were included in the study when they were triaged with the ESI and presented to one of the two EDs under study between 1 September 2004 and 1 June 2006.
  
  
  RESULTS
  Overall, 22.2% of the patients were triaged in ESI 5. Patients aged less than 40 years, women, and self-referred patients were most likely triaged in ESI 5, as well as patients presenting with complaints such as 'checkup appointments at the ED' and 'complaints of the skin'. Patients triaged in ESI 5 who were admitted or sent to the outpatient department were most likely elderly (aged above 65 years) and referred patients. They were also more likely to present with complaints such as 'postoperative complications, wound care problems, and plaster problems' and 'complaints of the genitourinary system'.
  
  
  CONCLUSIONS
  Although younger patients and women were more likely triaged in ESI 5, patients within this category who were admitted or sent to the outpatient department were more likely elderly and referred patients. Being admitted or sent to the outpatient department and triaged in ESI 5 indicates undertriage. Revision of the system is required to properly account for these patient groups.
authors.affiliation: Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands. I.vanderwulp@umcutrecht.nl
authors.forename: Ineke
authors.initials: I
authors.lastname: van der Wulp
authors.forename: Leontien M
authors.initials: LM
authors.lastname: Sturms
authors.forename: Augustinus J P
authors.initials: AJ
authors.lastname: Schrijvers
authors.forename: Henk F
authors.initials: HF
authors.lastname: van Stel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014218:Triage / Q000592:standards* / Q000706:statistics & numerical data; D055815:Young Adult