Medición del subtriaje como indicador de calidad y seguridad en un servicio de urgencias

Background: Undertriage or the underestimation of the urgency of the condition of a person arriving in an emergency department (ED) represents a measure of quality care. Aim: To estimate the prevalence of undertriage in a high complexity hospital of Argentina; to describe characteristics and morta...

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Autores principales:	Grande-Ratti,María Florencia, Esteban,Jorge Ariel, Mongelos,Damazo, Díaz,Mario Hernán, Giunta,Diego Hernán, Martínez,Bernardo Julio
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2020
Materias:	Emergency Medical Services Epidemiology Quality of Health Care Hospital Mortality Triage
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000500602
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spelling	oai:scielo:S0034-988720200005006022020-09-29Medición del subtriaje como indicador de calidad y seguridad en un servicio de urgenciasGrande-Ratti,María FlorenciaEsteban,Jorge ArielMongelos,DamazoDíaz,Mario HernánGiunta,Diego HernánMartínez,Bernardo Julio Emergency Medical Services Epidemiology Quality of Health Care Hospital Mortality Triage Background: Undertriage or the underestimation of the urgency of the condition of a person arriving in an emergency department (ED) represents a measure of quality care. Aim: To estimate the prevalence of undertriage in a high complexity hospital of Argentina; to describe characteristics and mortality of these patients. Material and Methods: All consultations admitted to the ED during 2014 were analyzed. Those assigned to a lower level of admission risk (classified as Emergency Severity Index -ESI- 3 to 5) but required hospitalization in intensive care units (ICU) as the first hospitalization place were considered as an undertriage. A random sample of correctly categorized admissions (ESI 1 or 2), who were subsequently hospitalized in the ICU, was selected as a comparison group. Results: The global undertriage prevalence was 0.30% (316/104,832). Among patients admitted to the ICU, the prevalence was 21% (316/1,461; 95% confidence intervals (CI) 19-24). The 316 patients whose severity was underestimated had a median age of 73 years, and admitted between 7 a.m. and 9 p.m. in a greater proportion. Overall hospital mortality was 8.9% (95% CI 6.78-11.38), and all deaths occurred after the patient was transferred from the emergency room. There were no differences in mortality between patients with correct triage or undertriage (11 and 7% respectively, p = 0.09). No differences were observed either in the total number of critical interventions during care in the first 24 hours. Significant differences were observed in requirements for mechanical ventilation (11 and 4% respectively, p = 0.01), orotracheal intubation (10 and 5% respectively p = 0.01) and non-invasive ventilation (8 and 4% respectively, p = 0.05). Conclusions: Undertriage rate in this series was low, but it can be improved.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.148 n.5 20202020-05-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000500602es10.4067/S0034-98872020000500602
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Emergency Medical Services Epidemiology Quality of Health Care Hospital Mortality Triage
spellingShingle	Emergency Medical Services Epidemiology Quality of Health Care Hospital Mortality Triage Grande-Ratti,María Florencia Esteban,Jorge Ariel Mongelos,Damazo Díaz,Mario Hernán Giunta,Diego Hernán Martínez,Bernardo Julio Medición del subtriaje como indicador de calidad y seguridad en un servicio de urgencias
description	Background: Undertriage or the underestimation of the urgency of the condition of a person arriving in an emergency department (ED) represents a measure of quality care. Aim: To estimate the prevalence of undertriage in a high complexity hospital of Argentina; to describe characteristics and mortality of these patients. Material and Methods: All consultations admitted to the ED during 2014 were analyzed. Those assigned to a lower level of admission risk (classified as Emergency Severity Index -ESI- 3 to 5) but required hospitalization in intensive care units (ICU) as the first hospitalization place were considered as an undertriage. A random sample of correctly categorized admissions (ESI 1 or 2), who were subsequently hospitalized in the ICU, was selected as a comparison group. Results: The global undertriage prevalence was 0.30% (316/104,832). Among patients admitted to the ICU, the prevalence was 21% (316/1,461; 95% confidence intervals (CI) 19-24). The 316 patients whose severity was underestimated had a median age of 73 years, and admitted between 7 a.m. and 9 p.m. in a greater proportion. Overall hospital mortality was 8.9% (95% CI 6.78-11.38), and all deaths occurred after the patient was transferred from the emergency room. There were no differences in mortality between patients with correct triage or undertriage (11 and 7% respectively, p = 0.09). No differences were observed either in the total number of critical interventions during care in the first 24 hours. Significant differences were observed in requirements for mechanical ventilation (11 and 4% respectively, p = 0.01), orotracheal intubation (10 and 5% respectively p = 0.01) and non-invasive ventilation (8 and 4% respectively, p = 0.05). Conclusions: Undertriage rate in this series was low, but it can be improved.
author	Grande-Ratti,María Florencia Esteban,Jorge Ariel Mongelos,Damazo Díaz,Mario Hernán Giunta,Diego Hernán Martínez,Bernardo Julio
author_facet	Grande-Ratti,María Florencia Esteban,Jorge Ariel Mongelos,Damazo Díaz,Mario Hernán Giunta,Diego Hernán Martínez,Bernardo Julio
author_sort	Grande-Ratti,María Florencia
title	Medición del subtriaje como indicador de calidad y seguridad en un servicio de urgencias
title_short	Medición del subtriaje como indicador de calidad y seguridad en un servicio de urgencias
title_full	Medición del subtriaje como indicador de calidad y seguridad en un servicio de urgencias
title_fullStr	Medición del subtriaje como indicador de calidad y seguridad en un servicio de urgencias
title_full_unstemmed	Medición del subtriaje como indicador de calidad y seguridad en un servicio de urgencias
title_sort	medición del subtriaje como indicador de calidad y seguridad en un servicio de urgencias
publisher	Sociedad Médica de Santiago
publishDate	2020
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000500602
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Medición del subtriaje como indicador de calidad y seguridad en un servicio de urgencias

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