Validation of the Canadian Pediatric Triage and Acuity Scale in the Emergency Department of a pediatric hospital in Argentina.
TL;DR
The adapted CPTAS scale, as adapted for use in Canadian Pediatric Triage and Acuity Scale, performed well in assessing urgency at this institution and its use could be considered at other centers in the region.
Abstract
Introduction. Overcrowding in pediatric emergency departments (PEDs) affects the quality of care. Triage is a strategy for optimizing this situation. Although validated systems exist, few have been validated in Latin America. This study evaluates the validity of the CPTAS (Canadian Pediatric Triage and Acuity Scale), as adapted for use in our center's PED, in predicting hospitalization and resource utilization. Materials and methods. A retrospective validation study of a randomized sample of visits classified by triage at the Emergency Department (from April 2021 to February 2022). The relationship between urgency level, hospital admission, and resource utilization was evaluated. Results. A total of 56 843 consultations were classified; 1500 were randomly selected, and 1159 were analyzed. The overall need for hospitalization was 15.27% and varied by urgency level: 100% for level 1, 61.48% for level 2, 13.67% for level 3, 3.38% for level 4, and 3.85% for level 5 (p <0.01). The odds ratio (OR) for admission was 49.15 (95%CI: 26.51-91.10) for levels 2 and 5, and 5.23 (95%CI: 2.97-9.19) for level 3 (p <0.01); AUC 0.83; five patients were admitted to the Intensive Care Unit, and no deaths were recorded. The use of ≥2 resources was 50% (level 1), 42.96% (level 2), 19.60% (level 3), 10.63% (level 4), and 1.92% (level 5) (p <0.01); and levels 2 and 3 showed a higher OR (p <0.01). Conclusion. The adapted CPTAS scale performed well in assessing urgency at our institution, and its use could be considered at other centers in the region.