Cameron et al reported a simple tool for identifying a patient who is likely to be admitted based on findings available during initial triage in the Emergency Department. The authors are from Glasgow Royal Infirmary and the University of Glasgow.
Patient selection: initial triage in the Emergency Department
Parameters:
(1) age of the patient in years
(2) NEWS score (National Early Warning Score of the NHS, from 0 to 20)
(3) Manchester triage category
(4) referral by general practitioner (GP)
(5) arrival by ambulance
(6) admitted less than 1 year ago
|
Parameter
|
Finding
|
Points
|
|
age in years
|
|
(age) / 10
|
|
NEWS
|
|
(NEWS)
|
|
Manchester triage
|
1 (immediate)
|
20
|
|
|
2 (very urgent)
|
10
|
|
|
3 (urgent)
|
5
|
|
|
4 or 5 (standard or nonurgent)
|
0
|
|
referral by GP
|
no
|
0
|
|
|
yes
|
10
|
|
arrival by ambulance
|
no
|
0
|
|
|
yes
|
5
|
|
admitted in past year
|
no
|
0
|
|
|
yes
|
5
|
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: around 1
• maximum score: around 71
• The higher the score the greater the likelihood of hospital admission, early return or subsequent admission within 28 days.
|
Score
|
Hospital Admission
|
|
0 to 3
|
2%
|
|
4
|
4.6%
|
|
5 to 33
|
(-0.003999* ((score)^3)) + (0.1654 * ((score)^2)) + (1.818 * (score)) - 8.053
|
|
34 to 38
|
92%
|
|
>= 39
|
> 95%
|
Performance:
• The area under the ROC curve for admissions was 0.88.
