Predictive value of the Manchester Triage System: evaluation of patients' clinical outcomes.

Helisamara Mota Guedes,Tânia Couto Machado Chianca,José Carlos Amado Martins

doi:10.1590/0034-7167.2015680107p

Abstract

To analyze the predictive value of the Manchester Triage System in relation to clinical outcome of patients. Prospective observational study of 577 patients admitted to the ER and subjected to risk classification. The Therapeutic Intervention Scoring System-28 (TISS-28) was used to measure the severity of patients (primary outcome) and secondary outcomes: high / transfer, death, and length of hospital stay. Descriptive and univariate analyzes were conducted. Patients classified as red are 10.7 times more likely to have scores above 14 in TISS-28 in relation to others. Patients classified as red have 5.9 times more chance of progression to death compared to others. Patients of high priority service are 1.5 times more likely to be hospitalized over five days than low priority. STM proved a good predictor of clinical outcomes.

Highlights

Triages carried out in emergency services without the use of protocols were made intuitively until recently and without using a specific methodology
We suggest that further studies conduct researches in order to confirm the length of hospital stay relationship and Manchester Triage System (MTS), since the studies found considered the time spent in the emergency room[3,4,5] and, this study considered the total time of the patient when admitted to the ER, until discharge/referral to another hospital or death
The present study found a majority of male patients (58.1%) with a mean age of 58.6 years old coded as yellow (46.5%)

Summary

Introduction

Triages carried out in emergency services without the use of protocols were made intuitively until recently and without using a specific methodology. They were not replicable to other health professionals and did not serve as a parameter for audits[1]. Public hospitals of Minas Gerais have sought to develop strategies for the implementation of this risk assessment tool for users seeking emergency care in public institutions. MTS presents 52 different flowcharts and a risk scale This scale has five categories identified by number, name, color, and target time to the initial medical evaluation. The individual can be coded in five colors: red (immediate care); orange (very urgent care); yellow (urgent care); green (standard care) and blue (non-urgent care)(4-6)

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Discussion

Conclusion