Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Two simple replacements for the Triage Early Warning Score to acilitate the South African Triage Scale in low resource settings
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Title
Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Two simple replacements for the Triage Early Warning Score to acilitate the South African Triage Scale in low resource settings
African Journal of Emergency Medicine
Two simple replacements for the Triage Early Warning Score to acilitate the South African Triage Scale in low resource settings
Subject
Low resource setting
Predictive scores
Emergency department
Predictive scores
Emergency department
Description
Background: The South African Triage Scale (SATS) requires the calculation of the Triage Early Warning Score
(TEWS), which takes time and is prone to error.
Aim: to derive and validate triage scores from a clinical database collected in a low-resource hospital in sub-
Saharan Africa over four years and compare them with the ability of TEWS to triage patients.
Methods: A retrospective observational study carried out in Kitovu Hospital, Masaka, Uganda as part of an
ongoing quality improvement project. Data collected on 4482 patients was divided into two equal cohorts: one
for the derivation of scores by logistic regression and the other for their validation.
Results: Two scores identified the largest number of patients with the lowest in-hospital mortality. A score based
on oxygen saturation, mental status and mobility had a c statistic for discrimination of 0.83 (95% CI 0.079–0.87)
in the derivation, and 0.81 (95% CI 0.77–0.86) in the validation cohort. Another score based on respiratory rate,
mental status and mobility had a c statistic of 0.82 (95% CI 0.078–0.87) in the derivation, and 0.81 (95% CI
0.77–0.86) in the validation cohort. The oxygen saturation-based score of zero points identified 51% of patients
in the derivation cohort who had in-hospital mortality rate of 0.5%, and 49% of patients in the validation cohort
who had in-hospital mortality of 1.0%. A respiratory rate-based score of zero points identified 45% in the
derivation cohort who had in-hospital mortality rate of 0.5%, and 44% of patients in the validation cohort who
had in-hospital mortality of 0.8%. Both scores had comparable performance to TEWS.
Conclusion: Two easy to calculate scores have comparable performance to TEWS and, therefore, could replace it
to facilitate the adoption of SATS in low-resource settings.
(TEWS), which takes time and is prone to error.
Aim: to derive and validate triage scores from a clinical database collected in a low-resource hospital in sub-
Saharan Africa over four years and compare them with the ability of TEWS to triage patients.
Methods: A retrospective observational study carried out in Kitovu Hospital, Masaka, Uganda as part of an
ongoing quality improvement project. Data collected on 4482 patients was divided into two equal cohorts: one
for the derivation of scores by logistic regression and the other for their validation.
Results: Two scores identified the largest number of patients with the lowest in-hospital mortality. A score based
on oxygen saturation, mental status and mobility had a c statistic for discrimination of 0.83 (95% CI 0.079–0.87)
in the derivation, and 0.81 (95% CI 0.77–0.86) in the validation cohort. Another score based on respiratory rate,
mental status and mobility had a c statistic of 0.82 (95% CI 0.078–0.87) in the derivation, and 0.81 (95% CI
0.77–0.86) in the validation cohort. The oxygen saturation-based score of zero points identified 51% of patients
in the derivation cohort who had in-hospital mortality rate of 0.5%, and 49% of patients in the validation cohort
who had in-hospital mortality of 1.0%. A respiratory rate-based score of zero points identified 45% in the
derivation cohort who had in-hospital mortality rate of 0.5%, and 44% of patients in the validation cohort who
had in-hospital mortality of 0.8%. Both scores had comparable performance to TEWS.
Conclusion: Two easy to calculate scores have comparable performance to TEWS and, therefore, could replace it
to facilitate the adoption of SATS in low-resource settings.
Creator
Lucien Wasingya-Kasereka , Pauline Nabatanzi , Immaculate Nakitende , Joan Nabiryo , Teopista Namujwiga , John Kellett , on behalf of the Kitovu Hospital Study Group
Source
www.elsevier.com/locate/afjem
Publisher
ELSEVIER
Date
30 November 2020
Contributor
PERI IRAWAN
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Citation
Lucien Wasingya-Kasereka , Pauline Nabatanzi , Immaculate Nakitende , Joan Nabiryo , Teopista Namujwiga , John Kellett , on behalf of the Kitovu Hospital Study Group, “Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Two simple replacements for the Triage Early Warning Score to acilitate the South African Triage Scale in low resource settings,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/2613.
African Journal of Emergency Medicine
Two simple replacements for the Triage Early Warning Score to acilitate the South African Triage Scale in low resource settings,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/2613.