title: The validity of the Canadian Triage and Acuity Scale in predicting resource utilization and the need for immediate life-saving interventions in elderly emergency department patients.
abstract: BACKGROUND
  We evaluated the validity of the Canadian Triage and Acuity Scale (CTAS) in elderly emergency department (ED) patients. In particular, we examined the sensitivity and specificity of the CTAS for identifying elderly patients who received an immediate life-saving intervention in the ED.
  
  
  METHODS
  We reviewed the medical records of consecutive patients who were 65 years of age or older and presented to a single academic ED within a three-month period. The CTAS triage scores were compared to actual patient course, including disposition, discharge outcome and resource utilization. We calculated the sensitivity and specificity of the CTAS triage for identifying patients who received an immediate intervention.
  
  
  RESULTS
  Of the 1903 consecutive patients who were ≥ 65 years of age, 113 (5.9%) had a CTAS level of 1, 174 (9.1%) had a CTAS level of 2, 1154 (60.6%) had a CTAS level of 3, 347 (18.2%) had a CTAS level of 4, and 115 (6.0%) had a CTAS level of 5. As a patient's triage score increased, the severity (such as mortality and intensive care unit admission) and resource utilization increased significantly. Ninety-four of the patients received a life-saving intervention within an hour following their arrival to the ED. The CTAS scores for these patients were 1, 2 and 3 for 46, 46 and 2 patients, respectively. The sensitivity and specificity of a CTAS score of ≤ 2 for identifying patients for receiving an immediate intervention were 97.9% and 89.2%, respectively.
  
  
  CONCLUSIONS
  The CTAS is a triage tool with high validity for elderly patients, and it is an especially useful tool for categorizing severity and for recognizing elderly patients who require immediate life-saving intervention.
authors: Emergency Team, Emergency Medical Center, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Ju Young
authors: JY
authors: Lee
authors: Sang Hoon
authors: SH
authors: Oh
authors: Eun Hee
authors: EH
authors: Peck
authors: Jung Min
authors: JM
authors: Lee
authors: Kyu Nam
authors: KN
authors: Park
authors: Soo Hyun
authors: SH
authors: Kim
authors: Chun Song
authors: CS
authors: Youn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002170:Canada; D016009:Chi-Square Distribution; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D004638:Emergency Treatment / Q000592:standards*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014218:Triage