title: Validity of the Pediatric Canadian Triage Acuity Scale in a tertiary children's hospital in Israel.
abstract: OBJECTIVE
  In 2015, the Israeli Ministry of Health issued national guidelines demanding the use of a five-level triage system in pediatric emergency departments (EDs). The present study aimed to evaluate the validity of the Pediatric Canadian Triage Acuity Scale (PedCTAS) in the ED of a tertiary children's hospital in Israel.
  
  
  METHODS
  A retrospective cohort study of all patients admitted between January 2011 and December 2015 was carried out. The proportion of hospitalization was the primary outcome measure. The secondary outcomes were proportion of admissions to the ICU, proportions of patients who left without being seen (LWBS), and length of stay (LOS) in the ED.
  
  
  RESULTS
  A total of 83 609 patients were included in our analysis. Triage levels 1-5 included 533 (0.6%), 4428 (5.3%), 46 461 (55.6%), 28 510 (34.1%), and 3677 (4.4%) patients, respectively. Hospitalization proportions were 70, 51, 28, 15, and 12% for triage levels 1, 2, 3, 4, and 5, respectively. Admission proportions to ICU were 24.2, 3.05, 0.24, 0.05, and 0.05% for PedCTAS levels 1, 2, 3, 4, and 5, respectively. The proportions of LWBS were 0.001, 0.002, and 0.005% for triage levels 3, 4, and 5, respectively. LOS was shorter as the triage level increased from 2 to 5.
  
  
  CONCLUSIONS
  Triage level was predictive of hospitalization, admission to the ICU, and proportions of LWBS and LOS in the ED. The findings suggest validity of the PedCTAS in this cohort. This is the first report of the performance of a triage tool in an Israeli ED.
authors.affiliation: Rappaport Faculty of Medicine, Technion-Israel Institute of Technology.
authors.forename: Raviv
authors.initials: R
authors.lastname: Allon
authors.affiliation: Department of Pediatric Emergency.
authors.forename: Oren
authors.initials: O
authors.lastname: Feldman
authors.affiliation: Department of Pediatric Emergency.
authors.forename: Anna
authors.initials: A
authors.lastname: Karminsky
authors.affiliation: Department of Pediatric Emergency.
authors.forename: Carmit
authors.initials: C
authors.lastname: Steinberg
authors.affiliation: Quality of Care Unit, Rambam Healthcare Campus, Haifa, Israel.
authors.forename: Ronit
authors.initials: R
authors.lastname: Leiba
authors.affiliation: Department of Pediatric Emergency.
authors.forename: Itai
authors.initials: I
authors.lastname: Shavit
mesh_terms: D000293:Adolescent; D002170:Canada; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007557:Israel; D008297:Male; D062072:Patient Acuity; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014218:Triage / Q000592:standards*