71. Factors predicting hospital admission for non-urgent patients triaged with the Canadian Triage and Acuity Scale (CTAS) in the Emergency Department. a retrospective study in Tertiary Center in Makkah, KSA.

Abstract

Background: Triage system is prioritizing patients according to their urgency to deal with overcrowding of non-urgent patients in the Emergency Department (ED). The aim of this study is to evaluate the admission of non-urgent patients in order to decrease the burden on the ED by triaging them away to the Primary Health Care (PHC). Design and Methods: This retrospective cohort study included all adult non-trauma ED visits in King Abdullah Medical City (KAMC), triaged as Canadian Triage and Acuity Scale (CTAS) IV and V, from May 9 to July 8, 2019. The data was extracted from KAMC database onto SPSS. Multivariate logistic regression was used to examine which factors could affect admission. Results: CTAS IV and CTAS V patients were 30.31% (1495/5066) of total ED visits. Admission was 6.02%; 5.8% for CTAS IV and 0.2% for CTAS V. All CTAS V admissions were elective. Nausea and vomiting (14.4%) were the most frequent chief complaints in the admitted group. The overall referral of non-urgent patients was 12.4% and bounce-back was 13.7%. Logistic regression showed that being tachypneic (OR: 6.68; 95%CI: 1.4-31.5), hypertensive (OR: 3.4; 95%CI: 2.2-5.4) or an oncology patient (OR: 2.85; 95%CI: 1.8-4.6) predicted hospital admission. Conclusion: All CTAS V cases can be safely triaged away to the PHC; CTAS IV can be either triaged away to PHC or to urgent care center, taking into consideration whether the patient is tachypneic, hypertensive or an oncology patient.