• Connie Leey-Echavarría, José Zorrilla-Riveiro, Anna Arnau, Mireia Fernàndez-Puigbó, Ester Sala-Barcons, and Emili Gené.
• Servicio de Urgencias y Emergencias, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, España. Programa de Doctorado en Ciencias de la Salud, Universidad Internacional de Catalunya, Barcelona, España.
• Emergencias. 2022 Jun 1; 34 (3): 165-173.

ObjectivesTo prospectively validate a model to predict hospital admission of patients given a low-priority classification on emergency department triage and to indicate the safety of reverse triage.Material And MethodsSingle-center observational study of a prospective cohort to validate a risk model incorporating demographic and emergency care process variables as well as vital signs. The cohort included emergency visits from patients over the age of 15 years with priority level classifications of IV and V according to the Andorran-Spanish triage system (Spanish acronym, MAT-SET) between October 2018 and June 2019. The area under the receiver operating characteristic curve (AUC) of the model was calculated to evaluate discrimination. Based on the model, we identified cut-off points to distinguish patients with low, intermediate, or high risk for hospital admission.ResultsA total of 2110 emergencies were included in the validation cohort; 109 patients (5.2%) were hospitalized. The median age was 43.5 years (interquartile range, 31-60.3 years); 55.5% were female. The AUC was 0.71 (95% CI, 0.64-0.75). The model identified 357 patients (16.9%) at low risk of hospitalization and 240 (11.4%) at high risk. A total of 15.8% of the high-risk patients and 2.8% of the low-risk patients were hospitalized.ConclusionThe validated model is able to identify risk for hospitalization among patients classified as low priority on triage. Patients identified as having high risk of hospitalization could be offered preferential treatment within the same level of priority at triage, while those at low risk of admission could be referred to a more appropriate care level on reverse triage.

15 keywords...

hide…