An alternative perspective on triage systems: the Progressive Real-world Optimization of Triage System (PROGRESS) study
Triage systems have remained largely unchanged since the 1990s and rely on expert consensus, with no single system consistently outperforming others in accurately identifying critically ill or urgent patients. This study aimed to determine whether incorporating additional tools improves the predicti...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2025-02-01
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| Series: | Emergency Care Journal |
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| Online Access: | https://www.pagepressjournals.org/ecj/article/view/13269 |
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| author | Arian Zaboli Francesco Brigo Serena Sibilio Gloria Brigiari Magdalena Massar Norbert Pfeifer Marta Parodi Eleonora Rella Gianni Turcato |
| author_facet | Arian Zaboli Francesco Brigo Serena Sibilio Gloria Brigiari Magdalena Massar Norbert Pfeifer Marta Parodi Eleonora Rella Gianni Turcato |
| author_sort | Arian Zaboli |
| collection | DOAJ |
| description | Triage systems have remained largely unchanged since the 1990s and rely on expert consensus, with no single system consistently outperforming others in accurately identifying critically ill or urgent patients. This study aimed to determine whether incorporating additional tools improves the predictive accuracy of the Manchester Triage System (MTS). A prospective, monocentric study was conducted at Merano Hospital (Italy) from June 1st to December 31st, 2023. A triage nurse and two ED physicians assigned patient priorities. The cohort was split for model derivation and validation. An ordinal logistic regression model was developed using MTS, the National Early Warning Score, and the Charlson Comorbidity Index, then tested on a validation cohort, bootstrapped to 5000 cases. Of the 1270 patients enrolled, 821 were in the derivation cohort and 449 in the validation cohort. The model outperformed MTS alone in most outcomes, except for predicting death at 72 hours and 7 days. Decision Curve Analysis confirmed its superiority in identifying urgent cases. Integrating multiple tools into triage models can enhance their performance, improving patient prioritization accuracy.
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| format | Article |
| id | doaj-art-9285eb2085ce4086aec3ff7bea329add |
| institution | OA Journals |
| issn | 2282-2054 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Emergency Care Journal |
| spelling | doaj-art-9285eb2085ce4086aec3ff7bea329add2025-08-20T02:00:29ZengPAGEPress PublicationsEmergency Care Journal2282-20542025-02-0110.4081/ecj.2025.13269An alternative perspective on triage systems: the Progressive Real-world Optimization of Triage System (PROGRESS) studyArian Zaboli0Francesco Brigo1Serena Sibilio2Gloria Brigiari3Magdalena Massar4Norbert Pfeifer5Marta Parodi6Eleonora Rella7Gianni Turcato8Innovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), BolzanoInnovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), BolzanoUniversität Basel Department Public Health, Institute of Nursing Science, Basel, BSUnit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, PadovaInnovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), BolzanoDepartment of Emergency Medicine, Hospital of Merano-Meran (SABES-ASDAA), Merano-Meran, Italy; Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, SalzburgDepartment of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), SantorsoDepartment of Emergency Medicine, Hospital of Merano-Meran (SABES-ASDAA), Merano-Meran, Italy; Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, SalzburgDepartment of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), SantorsoTriage systems have remained largely unchanged since the 1990s and rely on expert consensus, with no single system consistently outperforming others in accurately identifying critically ill or urgent patients. This study aimed to determine whether incorporating additional tools improves the predictive accuracy of the Manchester Triage System (MTS). A prospective, monocentric study was conducted at Merano Hospital (Italy) from June 1st to December 31st, 2023. A triage nurse and two ED physicians assigned patient priorities. The cohort was split for model derivation and validation. An ordinal logistic regression model was developed using MTS, the National Early Warning Score, and the Charlson Comorbidity Index, then tested on a validation cohort, bootstrapped to 5000 cases. Of the 1270 patients enrolled, 821 were in the derivation cohort and 449 in the validation cohort. The model outperformed MTS alone in most outcomes, except for predicting death at 72 hours and 7 days. Decision Curve Analysis confirmed its superiority in identifying urgent cases. Integrating multiple tools into triage models can enhance their performance, improving patient prioritization accuracy. https://www.pagepressjournals.org/ecj/article/view/13269Triageaccuracypatient prioritizationearly warning scoreemergency nursetriage model |
| spellingShingle | Arian Zaboli Francesco Brigo Serena Sibilio Gloria Brigiari Magdalena Massar Norbert Pfeifer Marta Parodi Eleonora Rella Gianni Turcato An alternative perspective on triage systems: the Progressive Real-world Optimization of Triage System (PROGRESS) study Emergency Care Journal Triage accuracy patient prioritization early warning score emergency nurse triage model |
| title | An alternative perspective on triage systems: the Progressive Real-world Optimization of Triage System (PROGRESS) study |
| title_full | An alternative perspective on triage systems: the Progressive Real-world Optimization of Triage System (PROGRESS) study |
| title_fullStr | An alternative perspective on triage systems: the Progressive Real-world Optimization of Triage System (PROGRESS) study |
| title_full_unstemmed | An alternative perspective on triage systems: the Progressive Real-world Optimization of Triage System (PROGRESS) study |
| title_short | An alternative perspective on triage systems: the Progressive Real-world Optimization of Triage System (PROGRESS) study |
| title_sort | alternative perspective on triage systems the progressive real world optimization of triage system progress study |
| topic | Triage accuracy patient prioritization early warning score emergency nurse triage model |
| url | https://www.pagepressjournals.org/ecj/article/view/13269 |
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