Predictive Value of Initial Triage Vital Signs for Critically Ill Older Adults
Introduction: Triage of patients is critical to patient safety, yet no clear information exists as to the utility of initial vital signs in identifying critically ill older emergency department (ED) patients. The objective of this study is to evaluate a set of initial vital sign thresholds as predic...
| Auteurs principaux: | , , , , , , , , , , |
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| Format: | Article |
| Langue: | English |
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eScholarship Publishing, University of California
2013-09-01
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| Collection: | Western Journal of Emergency Medicine |
| Sujets: | |
| Accès en ligne: | http://escholarship.org/uc/item/0fw1w5nv# |
| _version_ | 1828520157448765440 |
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| author | Jan Busby-Whitehead Charles B Cairns Frances S Shofer Brenda K McCall Ezequiel Zamora Cory Forbach Kevin J Biese Timothy F Platts-Mills Paul W Stewart Michael A LaMantia John S Kizer |
| author_facet | Jan Busby-Whitehead Charles B Cairns Frances S Shofer Brenda K McCall Ezequiel Zamora Cory Forbach Kevin J Biese Timothy F Platts-Mills Paul W Stewart Michael A LaMantia John S Kizer |
| author_sort | Jan Busby-Whitehead |
| collection | DOAJ |
| description | Introduction: Triage of patients is critical to patient safety, yet no clear information exists as to the utility of initial vital signs in identifying critically ill older emergency department (ED) patients. The objective of this study is to evaluate a set of initial vital sign thresholds as predictors of severe illness and injury among older adults presenting to the ED.Methods: We reviewed all visits by patients aged 75 and older seen during 2007 at an academic ED serving a large community of older adults. Patients’ charts were abstracted for demographic and clinical information including vital signs, via automated electronic methods. We used bivariate analysis to investigate the relationship between vital sign abnormalities and severe illness or injury, defined as intensive care unit (ICU) admission or ED death. In addition, we calculated likelihood ratios for normal and abnormal vital signs in predicting severe illness or injury.Results: 4,873 visits by patients aged 75 and above were made to the ED during 2007, and of these 3,848 had a complete set of triage vital signs. For these elderly patients, the sensitivity and specificity of an abnormal vital sign taken at triage for predicting death or admission to an ICU were 73% (66,81) and 50% (48,52) respectively (positive likelihood ratio 1.47 (1.30,1.60); negative likelihood ratio 0.54 (0.30,0.60).Conclusion: Emergency provider assessment and triage scores that rely primarily on initial vital signs are likely to miss a substantial portion of critically ill older adults. [West J Emerg Med. 2013;14(5):453–460.] |
| first_indexed | 2024-12-11T19:24:48Z |
| format | Article |
| id | doaj.art-effe7f7b10d4497c93b5d3b6de958d82 |
| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-9018 |
| language | English |
| last_indexed | 2024-12-11T19:24:48Z |
| publishDate | 2013-09-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-effe7f7b10d4497c93b5d3b6de958d822022-12-22T00:53:25ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182013-09-01145453460Predictive Value of Initial Triage Vital Signs for Critically Ill Older AdultsJan Busby-WhiteheadCharles B CairnsFrances S ShoferBrenda K McCallEzequiel ZamoraCory ForbachKevin J BieseTimothy F Platts-MillsPaul W StewartMichael A LaMantiaJohn S KizerIntroduction: Triage of patients is critical to patient safety, yet no clear information exists as to the utility of initial vital signs in identifying critically ill older emergency department (ED) patients. The objective of this study is to evaluate a set of initial vital sign thresholds as predictors of severe illness and injury among older adults presenting to the ED.Methods: We reviewed all visits by patients aged 75 and older seen during 2007 at an academic ED serving a large community of older adults. Patients’ charts were abstracted for demographic and clinical information including vital signs, via automated electronic methods. We used bivariate analysis to investigate the relationship between vital sign abnormalities and severe illness or injury, defined as intensive care unit (ICU) admission or ED death. In addition, we calculated likelihood ratios for normal and abnormal vital signs in predicting severe illness or injury.Results: 4,873 visits by patients aged 75 and above were made to the ED during 2007, and of these 3,848 had a complete set of triage vital signs. For these elderly patients, the sensitivity and specificity of an abnormal vital sign taken at triage for predicting death or admission to an ICU were 73% (66,81) and 50% (48,52) respectively (positive likelihood ratio 1.47 (1.30,1.60); negative likelihood ratio 0.54 (0.30,0.60).Conclusion: Emergency provider assessment and triage scores that rely primarily on initial vital signs are likely to miss a substantial portion of critically ill older adults. [West J Emerg Med. 2013;14(5):453–460.]http://escholarship.org/uc/item/0fw1w5nv#elderlyemergency departmentvital signstriage |
| spellingShingle | Jan Busby-Whitehead Charles B Cairns Frances S Shofer Brenda K McCall Ezequiel Zamora Cory Forbach Kevin J Biese Timothy F Platts-Mills Paul W Stewart Michael A LaMantia John S Kizer Predictive Value of Initial Triage Vital Signs for Critically Ill Older Adults Western Journal of Emergency Medicine elderly emergency department vital signs triage |
| title | Predictive Value of Initial Triage Vital Signs for Critically Ill Older Adults |
| title_full | Predictive Value of Initial Triage Vital Signs for Critically Ill Older Adults |
| title_fullStr | Predictive Value of Initial Triage Vital Signs for Critically Ill Older Adults |
| title_full_unstemmed | Predictive Value of Initial Triage Vital Signs for Critically Ill Older Adults |
| title_short | Predictive Value of Initial Triage Vital Signs for Critically Ill Older Adults |
| title_sort | predictive value of initial triage vital signs for critically ill older adults |
| topic | elderly emergency department vital signs triage |
| url | http://escholarship.org/uc/item/0fw1w5nv# |
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