• Tomás Hernández Ruipérez, César Leal Costa, María de Gracia Adánez Martínez, Bartolomé García Pérez, Daniel Nova López, and José Luis Díaz Agea.
• Servicio de Urgencias. Hospital Clínico Universitario Virgen de la Arrixaca. Simulación Clínica. Murcia, España.
• Emergencias. 2015 Oct 1; 27 (5): 301-306.

ObjectivesTo determine whether the Emergency Severity Index (ESI) is valid for triage according to evidence based on classifying real patients in a general referral hospital's emergency department.Material And MethodsObservational, cross-sectional descriptive study carried out in the emergency department of Hospital Clínico Universitario Virgen de la Arrixaca in Murcia. Thirty-two nurses used the ESI algorithm to triage 410 patients as they arrived seeking care. The results were compared to a gold standard (a triage expert's opinion, which was later confirmed by an expert committee after discussion, if necessary, of cases for which opinions were not unanimous). We calculated sensitivity, specificity, under- and over-triage rates, as well as descriptive statistics about resource assignment, exitus, patients who left without being seen, destination on discharge, and times.ResultsESI was highly correlated with resources (ρ = -0.717, P < .01) and moderately correlated with destination on discharge (ρ = -0.437, P < .01). Regarding time spent in the department, we found that patients assigned ESI levels 1 and 2 had significantly longer stays, and those assigned ESI levels 4 and 5 had significantly shorter stays (p < 0,001). Interobserver agreement was good or very good, indicating that this triage tool is reliable.ConclusionThis pilot of the ESI triage algorithm in the emergency department of a referral hospital found evidence supporting the system's validity.

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