Italian validation of the Manchester Triage System towards short-term mortality: a prospective observational study

Submitted: 2 May 2023
Accepted: 30 June 2023
Published: 11 July 2023
Abstract Views: 1395
PDF: 539
Supplementary Materials: 131
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The study aimed to validate the Manchester Triage System in a hospital setting using data for short- and medium-term death rates. A prospective observational study was conducted at the Emergency Department of Merano Hospital for two years. The discriminatory ability of MTS was tested using AUROCs and contingency tables, reporting sensitivity and specificity levels for each study outcome. A total of 98,443 patients were enrolled, 237 of whom died within 72h; 422 patients died within seven days, and 1025 died within 30 days. The MTS demonstrated excellent discriminatory ability, reporting AUROC values of 0.890 for death within 72h, 0.853 for death within seven days, and 0.781 for death within 30 days. A sensitivity of 87.7% and a specificity of 79.4% were reported for death at 72h, while a sensitivity of 69.6% and a specificity of 79.8% were reported for death at 30 days. The MTS has proven to be a good triage system capable of accurately identifying patients who are at risk of death in the short or medium term.

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Zaboli A, Brigo F, Sibilio S, et al. The impact of COVID-19 pandemic on the urgency of patients admitted to the emergency department. Int Emerg Nurs 2022;65:101229. DOI: https://doi.org/10.1016/j.ienj.2022.101229
Gilbert A, Brasseur E, Petit M, Donneau AF, D'Orio V, Ghuysen A. Advanced triage to redirect non-urgent Emergency Department visits to alternative care centers: the PERSEE algorithm. Acta Clin Belg 2022;77:571-8. DOI: https://doi.org/10.1080/17843286.2021.1914948
Hinson JS, Martinez DA, Cabral S, et al. Triage Performance in Emergency Medicine: A Systematic Review. Ann Emerg Med 2019;74:140-52. DOI: https://doi.org/10.1016/j.annemergmed.2018.09.022
Zachariasse JM, van der Hagen V, Seiger N, et al. Performance of triage systems in emergency care: a systematic review and meta-analysis. BMJ Open 2019;9:e026471. DOI: https://doi.org/10.1136/bmjopen-2018-026471
Christ M, Grossmann F, Winter D, Bingisser R, Platz E. Modern triage in the emergency department. Dtsch Arztebl Int 2010;107:892-8. DOI: https://doi.org/10.3238/arztebl.2010.0892
Garrafa E, Levaggi R, Miniaci R, Paolillo C. When fear backfires: Emergency department accesses during the Covid-19 pandemic. Health Policy 2020;124:1333-9. DOI: https://doi.org/10.1016/j.healthpol.2020.10.006
Brigo F, Zaboli A, Rinaldi F, et al. The Manchester Triage System's performance in clinical risk prioritisation of patients presenting with headache in emergency department: A retrospective observational study. J Clin Nurs 2022;31:2553-61. DOI: https://doi.org/10.1111/jocn.16073
Azeredo TR, Guedes HM, Rebelo de Almeida RA, et al. Efficacy of the Manchester Triage System: a systematic review. Int Emerg Nurs 2015;23:47-52. DOI: https://doi.org/10.1016/j.ienj.2014.06.001
Zaboli A, Ausserhofer D, Sibilio S, et al. Nurse triage accuracy in the evaluation of syncope according to European Society of Cardiology guidelines. Eur J Cardiovasc Nurs 2022;21:280-6. DOI: https://doi.org/10.1093/eurjcn/zvab063
Gräff I, Latzel B, Glien P, et al. Validity of the Manchester Triage System in emergency patients receiving life-saving intervention or acute medical treatment-A prospective observational study in the emergency department. J Eval Clin Pract 2019;25:398-403. DOI: https://doi.org/10.1111/jep.13030
Parenti N, Reggiani ML, Iannone P, et al. A systematic review on the validity and reliability of an emergency department triage scale, the Manchester Triage System. Int J Nurs Stud 2014;51:1062-9. DOI: https://doi.org/10.1016/j.ijnurstu.2014.01.013
Canzan F, Allegrini E, Mezzalira E, et al. Il processo decisionale dell’infermiere nell’attribuzione del codice di triage: uno studio qualitativa descrittivo [Nurse decision making in triage cose assignment: a qualitative descriptive study]. Assist Inferm Ric 2022;41:15-22.
Zachariasse JM, Seiger N, Rood PP, et al. Validity of the Manchester Triage System in emergency care: A prospective observational study. PLoS One 2017;12:e0170811. DOI: https://doi.org/10.1371/journal.pone.0170811
Gräff I, Goldschmidt B, Glien P, et al. The German Version of the Manchester Triage System and its quality criteria--first assessment of validity and reliability. PLoS One 2014;9:e88995. DOI: https://doi.org/10.1371/journal.pone.0088995
Brutschin V, Kogej M, Schacher S, et al. The presentational flow chart "unwell adult" of the Manchester Triage System-Curse or blessing? PLoS One 2021;16:e0252730. DOI: https://doi.org/10.1371/journal.pone.0252730
Zaboli A, Sibilio S, Magnarelli G, et al. Daily triage audit can improve nurses' triage stratification: A pre-post study. J Adv Nurs 2023;79:605-15. DOI: https://doi.org/10.1111/jan.15521
Kuriyama A, Urushidani S, Nakayama T. Five-level emergency triage systems: variation in assessment of validity. Emerg Med J 2017;34:703-10. DOI: https://doi.org/10.1136/emermed-2016-206295
Challen K. How good is triage, and what is it good for? Emerg Med J 2017;34:702. DOI: https://doi.org/10.1136/emermed-2017-206973
van Dam CS, Hoogendijk EO, Mooijaart SP, et al. A narrative review of frailty assessment in older patients at the emergency department. Eur J Emerg Med 2021;28:266-76. DOI: https://doi.org/10.1097/MEJ.0000000000000811
Elliott A, Hull L, Conroy SP. Frailty identification in the emergency department-a systematic review focussing on feasibility. Age Ageing 2017;46:509-13. DOI: https://doi.org/10.1093/ageing/afx019
Brouns SHA, Mignot-Evers L, Derkx F, et al. Performance of the Manchester triage system in older emergency department patients: a retrospective cohort study. BMC Emerg Med 2019;19:3. DOI: https://doi.org/10.1186/s12873-018-0217-y
Elliott A, Taub N, Banerjee J, et al. Does the Clinical Frailty Scale at Triage Predict Outcomes From Emergency Care for Older People? Ann Emerg Med 2021;77:620-7. DOI: https://doi.org/10.1016/j.annemergmed.2020.09.006
Salvi F, Morichi V, Grilli A, et al. Screening for frailty in elderly emergency department patients by using the Identification of Seniors At Risk (ISAR). J Nutr Health Aging 2012;16:313-8. DOI: https://doi.org/10.1007/s12603-011-0155-9

How to Cite

Zaboli, A., Sibilio, S., Cipriano, A., Park, N., Bonora, A., Pfeifer, N., Giudiceandrea, A., Brigo, F., & Turcato, G. (2023). Italian validation of the Manchester Triage System towards short-term mortality: a prospective observational study. Emergency Care Journal, 19(3). https://doi.org/10.4081/ecj.2023.11443