P564Comparison between heart failure triage scale and emergency severity index to triage heart failure patients

Abstract

Introduction: It is unclear whether triage scales are able to identify high risk patients with heart failure (HF) or not. Purpose: The aims of study were i) develop heart failure triage scale (HFTS) and ii) compare the effect of HFTS and emergency severity index (ESI) on mistriage among patients with heart failure who present to the emergency department (ED). Methods: A randomized clinical trial was conducted from April to June 2017. HF patients with dyspnea were randomly assigned to HFTS or ESI groups. Triage level, used resources and time to electrocardiogram (ECG) were compared between both groups among HF patients who admitted to coronary care unit (CCU), cardiac unit (CU) and discharged patients from the ED. Content validity was examined using Kappa designating agreement on relevance (k∗). Reliability of both scale was evaluated using interobserver agreement (Kappa). Results: Seventy three and 74 HF patients were assigned to HFTS and ESI groups respectively. Time to ECG in HFTS group was significantly shorter than that of ESI group (2.05 vs. 16.82 min). Triage level between HFTS and ESI groups was significantly different among patients admitted to CCU (1.0 vs. 2.8), cardiac unit (2.26 vs. 3.06) and discharged patients from the ED (3.53 vs. 2.86). Used resources in HFTS group was significantly different among triage levels (H = 25.89; df = 3; p<0.001). Conclusions: HFTS provides a more accurate method for triaging HF patients compared to ESI. It is recommended to make use of HFTS to triage HF patients in the ED.