Comparison of systematic triage with clinical assessment in prediction of short-term mortality Anne Kristine Servais Iversen1, Jakob Lundager Forberg2,

Præsentationer af emnet: "Comparison of systematic triage with clinical assessment in prediction of short-term mortality Anne Kristine Servais Iversen1, Jakob Lundager Forberg2,"— Præsentationens transcript:

1 Comparison of systematic triage with clinical assessment in prediction of short-term mortality
Anne Kristine Servais Iversen1, Jakob Lundager Forberg2, MD, PhD, Morten Schou3, MD, PhD, Prof. Lars S. Rasmussen4, MD, DMSci, Prof. Lars Køber5, MD, DMSci, Kasper Iversen3, MD, DMSci 1Department of Cardiology and Endocrinology, Hospital Of Northern Zealand, Hillerød Hospital, Denmark, 2Department Of Emergency Medicine, Hospital Of Northern Zealand, Hillerød Hospital, Denmark, 3Department Of Cardiology, Herlev Hospital, University of Copenhagen, Denmark, 4Department of Anaesthesia, Centre Of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Denmark, 5Department Of Cardiology, Rigshospitalet, University of Copenhagen, Denmark Corresponding and presenting author:

2 Formål 1 Undersøge den prognostiske værdi af en
Klinisk vurdering af en patients triage behov vs. Systematiseret triage algoritme

3 Eyeball triage 2 Hurtig, umiddelbar vurdering af patienten
Klinisk fremtræden Det primære symptom

4 Danish Emergency Process Triage (DEPT)
3 Danish Emergency Process Triage (DEPT) Algoritme baseret risiko-stratificering Symptomkort Vitale parametre

5 Baggrund 4 Systematiseret triage indført på alle danske FAM
Kun ét studie har tidligere sammenlignet formaliseret triage med en klinisk vurdering

6 Metode 5 3 måneders dataindsamling, 24 timer i døgnet 6383 patienter
Dobbelt triage af alle patienter - DEPT 98.5 % - Eyeball 99.9 %

7 Primære endepunkt Statistik 6 30-dages mortalitet
Receiver Operating Characteristic curves (ROC) PPV, NPV, Sensitivitet og Specificitet Hazard Ratios Kappa-statistik

8 7 Fordeling mellem triagekategorier P< 0.01 30 dages mortalitet 4,2% DEPT Eyeball Grøn 2061 (33%) 2352 (37%) Gul 2487 (40%) 2804 (45%) Orange 1704 (27%) 1016 (16%) Rød 38 (1%) 118 (2%)

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10 9 PPV, NPV, Sensitivitet og Specificitet

11 10 Hazard Ratios

12 11 Kappa: 0.05

13 Styrker Svagheder 12 Stor studiedatabase Høj gennemførselsrate
Eyeball triage udført at bioanalytikere Svagheder Ingen randomisering mellem triage metoder

14 Konklusion 13 Dårlig sammenhæng mellem vurderinger
Eyeball triage er bedre til at identificere patienter i både høj og lav risiko i forhold til 30-dages mortalitet

15 14 Kontakt Posterplads: B5

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