An Obstetrical Triage Acuity Scale Does Not Predict Hospital Admission [12A

Abstract

INTRODUCTION: To evaluate the application of a five-tiered Obstetrical Triage Acuity Scale (OTAS) in a tertiary care center by assessing the relationship between the triage score and admission rates. METHODS: A retrospective chart review over a 2 month period in 2014 was conducted. The previously validated OTAS score for obstetrics was assigned to each patient. Seven scoring parameters were used to assign a final score, stratified into 5 categories: 1) resuscitative, 2) emergent, 3) urgent, 4) less urgent, and 5) non-urgent. Characteristics of patients assigned to each scoring group were compared using the Chi-square test. Rates of admission amongst the groups were also compared. RESULTS: Eight hundred and thirty five patients were included. The mean gestational age of patients was 35.9 weeks. The median number of triage visits was 2 (1–11) with 112 (13.4%) patients classified as triage super users (above 5 visits). The most frequently assigned scores were level 4 (34.7%) and level 2 (32.1%). Only 4 patients were assigned a level 1. Hospital admission rates were significantly associated with OTAS score. Seventy-five percent of level 1, 56.9% of level 4 and 53.8% of level 3 women were admitted. Most level 5 (87.1%) and level 2 (65.9%) visits were discharged to home. CONCLUSION: The OTAS in our population did not predict hospital admission, because level 2 patients were most likely to be discharged home. Level 3 and level 4 encounters were also likely to be admitted and delivered during the same visit; most term labor admissions will occur in these two levels.