Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=25504659
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\25504659
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Emerg+Med+J
2015 ; 32
(9
): 690-7
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Identification of the severe sepsis patient at triage: a prospective analysis of
the Australasian Triage Scale
#MMPMID25504659
Chamberlain DJ
; Willis E
; Clark R
; Brideson G
Emerg Med J
2015[Sep]; 32
(9
): 690-7
PMID25504659
show ga
OBJECTIVE: This study aims to investigate the accuracy and validity of the
Australasian Triage Scale (ATS) as a tool to identify and manage in a timely
manner the deteriorating patient with severe sepsis. METHODS: This was a
prospective observational study conducted in five sites of adult patients.
Keywords and physiological vital signs data from triage documentation were
analysed for the 'identified' status compared with confirmed diagnosis of severe
sepsis after admission to the intensive care unit. The primary outcome is the
accuracy and validity of the ATS Triage scale categories to identify a
prespecified severe sepsis population at triage. Secondary outcome measures
included time compliance, antimicrobial administration and mortality prediction.
Statistical analysis included parameters of diagnostic performance. Adjusted
multivariate logistic regression analysis was applied to mortality prediction.
RESULTS: Of 1022 patients meeting the criteria for severe sepsis, 995 were
triaged through the emergency department, 164 with shock. Only 53% (n=534) were
identified at triage. The overall sensitivity of the ATS to identify severe
sepsis was 71%. ATS 3 was the most accurate (likelihood ratio positive, 2.45,
positive predictive value 0.73) and ATS 2 the most valid (area under the curve
0.567) category. Identified cases were more likely to survive (OR 0.81, 95% CI
0.697 to 0.94, p<0.007). The strongest bias-adjusted predictors of mortality were
circulatory compromise variable (1.78, 95% CI 1.34 to 1.41, p<0.001), lactate >4
(OR 1.63, 95% CI 1.10 to 2.89, p<0.001) and ATS 1 category (OR 1.55, 95% CI 1.09
to 2.35, p<0.005). CONCLUSIONS: The ATS and its categories is a sensitive and
moderately accurate and valid tool for identifying severe sepsis in a
predetermined group, but lacks clinical efficacy and safety without further
education or quality improvement strategies targeted to the identification of
severe sepsis.
free
free
free
