Ondertriage bij patiënten in de ESI categorie 5

van dW, I, Sturms LM, Schrijvers AJ, van Stel HF. An observational study of patients triaged in category 5 of the Emergency Severity Index. Eur J Emerg Med 2009 Oct 8

DOELSTELLING: Patiënten die getrieerd zijn in categorie 5 van de Emergency Severity Index (ESI) hebben geen middelen nodig vóór ontslag van de spoedeisende hulp afdeling. We bestudeerden de kenmerken van de patiënten in deze categorie en richtten ons op degenen die zijn opgenomen of naar de polikliniek zijn doorgestuurd na hun bezoek aan de spoedeisende hulp

OBJECTIVE: Patients triaged in category 5 of the Emergency Severity Index (ESI) do not need any resources before discharge from the emergency department (ED). We studied the characteristics of these patients and focused on those who were admitted or sent to the outpatient department after their ED visit. METHODS: A retrospective observational study was conducted on 117 740 patient presentations. Patients were included in the study when they were triaged with the ESI and presented to one of the two EDs under study between 1 September 2004 and 1 June 2006. RESULTS: Overall, 22.2% of the patients were triaged in ESI 5. Patients aged less than 40 years, women, and self-referred patients were most likely triaged in ESI 5, as well as patients presenting with complaints such as 'checkup appointments at the ED' and 'complaints of the skin'. Patients triaged in ESI 5 who were admitted or sent to the outpatient department were most likely elderly (aged above 65 years) and referred patients. They were also more likely to present with complaints such as 'postoperative complications, wound care problems, and plaster problems' and 'complaints of the genitourinary system'. CONCLUSION: Although younger patients and women were more likely triaged in ESI 5, patients within this category who were admitted or sent to the outpatient department were more likely elderly and referred patients. Being admitted or sent to the outpatient department and triaged in ESI 5 indicates undertriage. Revision of the system is required to properly account for these patient groups

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