The predictive validity of RETTS-HEV as an acuity triage tool in the emergency department of a Danish Regional Hospital.
BACKGROUND
The Rapid Emergency Triage and Treatment System - Hospital Unit West (RETTS-HEV) is a triage system used in the emergency department (ED) in Herning, Denmark, since 2010. It categorizes patients according to priority and defines a time limit on how long patients can wait before being seen by a doctor depending on the severity of their condition. The purpose of this study was to determine the predictive validity of RETTS-HEV by measuring the association between triage scores and outcomes such as the admission rate, the length of stay (LOS), and mortality.


METHODS
We performed an observational cohort study by examining the medical records of all patients who attended the ED from 1 September 2012 to 30 November 2012, at the Regional Hospital West Jutland in Herning, Denmark (N=4680). We defined the following outcomes to make associations with the patients' triage category: in-hospital mortality, and 30, 60, and 90-day mortalities, the hospital LOS and the admission rate, on the basis of complete information from the Danish National Patient Registry.


RESULTS
The distribution of age, comorbidity, admission, LOS, and mortality over triage categories differed as expected. After making adjustments for these differences, we found a consistent association between triage categories and in-hospital mortality, and 30, 60, and 90-day mortalities, the hospital LOS, and the admission rate.


CONCLUSIONS
RETTS-HEV was found to be closely related to all examined outcomes, and therefore useful in the risk stratification of ED patients.
Departments of aEmergency bOccupational Medicine, Regional Hospital of Herning, Herning, Denmark.
Noel
N
Pérez
Louise
L
Nissen
Rasmus F
RF
Nielsen
Poul
P
Petersen
Karin
K
Biering
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003718:Denmark; D016529:Emergency Nursing / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006769:Hospitals, General; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009733:Nursing Diagnosis / Q000592:standards; D010343:Patient Admission / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D013997:Time Factors; D014218:Triage / Q000592:standards*