Is the South African Triage Scale Valid for Use in Afghanistan, Haiti and Sierra Leone?

Hdl Handle:
http://hdl.handle.net/10144/618958
Title:
Is the South African Triage Scale Valid for Use in Afghanistan, Haiti and Sierra Leone?
Authors:
Dalwai, M; Valles, P; Twomey, M; Nzomukunda, Y; Jonjo, P; Sasikumar, M; Nasim, M; Razaaq, A; Gayraud, O; Jecrois, P; Wallis, L; Tayler-Smith, K
Journal:
BMJ Global Health
Abstract:
Objective To assess the validity of the South African Triage Scale (SATS) in four Médecins Sans Frontières (MSF)-supported emergency departments (ED, two trauma-only sites, one mixed site (both medical and trauma cases) and one paediatric-only site) in Afghanistan, Haiti and Sierra Leone. Methods This was a retrospective cohort study conducted between June 2013 and June 2014. Validity was assessed by comparing patients’ SATS ratings with their final ED outcome (ie, hospital admission, death or discharge). Results In the two trauma settings, the SATS demonstrated good validity: it accurately predicted an increase in the likelihood of mortality and hospitalisation across incremental acuity levels (p<0.001) and ED outcomes for ‘green’ and ‘red’ patients matched the predicted ED outcomes in 84%–99% of cases. In the mixed ED, the SATS was able to predict an incremental increase in hospitalisation (p<0.001) across both trauma and non-trauma cases. In the paediatric-only settings, SATS was able to predict an incremental increase in hospitalisation in the non-trauma cases only (p<0.001). However, 87% (non-trauma) and 94% (trauma) of ‘red’ patients in the mixed-medical setting were overtriaged and 76% (non-trauma) and 100% (trauma) of ‘green’ patients in the paediatric settings were undertriaged. Conclusion The SATS is a valid tool for trauma-only settings in low-resource countries. Its use in mixed settings seems justified, but context-specific assessments would seem prudent. Finally, in paediatric settings with endemic malaria, adding haemoglobin level to the SATS discriminator list may help to improve the undertriage of patients with malaria.
Publisher:
BMJ Publishing Group Ltd
Issue Date:
15-Jun-2017
URI:
http://hdl.handle.net/10144/618958
Submitted date:
2017-07-18
Language:
en
Appears in Collections:
Emergencies/refugees

Full metadata record

DC FieldValue Language
dc.contributor.authorDalwai, Men
dc.contributor.authorValles, Pen
dc.contributor.authorTwomey, Men
dc.contributor.authorNzomukunda, Yen
dc.contributor.authorJonjo, Pen
dc.contributor.authorSasikumar, Men
dc.contributor.authorNasim, Men
dc.contributor.authorRazaaq, Aen
dc.contributor.authorGayraud, Oen
dc.contributor.authorJecrois, Pen
dc.contributor.authorWallis, Len
dc.contributor.authorTayler-Smith, Ken
dc.date.accessioned2017-07-19T13:25:02Z-
dc.date.available2017-07-19T13:25:02Z-
dc.date.issued2017-06-15-
dc.date.submitted2017-07-18-
dc.identifier.citationIs the South African Triage Scale Valid for Use in Afghanistan, Haiti and Sierra Leone? BMJ Glob Health 2017;2:e000160. doi:10.1136/ bmjgh-2016-000160en
dc.identifier.urihttp://hdl.handle.net/10144/618958-
dc.description.abstractObjective To assess the validity of the South African Triage Scale (SATS) in four Médecins Sans Frontières (MSF)-supported emergency departments (ED, two trauma-only sites, one mixed site (both medical and trauma cases) and one paediatric-only site) in Afghanistan, Haiti and Sierra Leone. Methods This was a retrospective cohort study conducted between June 2013 and June 2014. Validity was assessed by comparing patients’ SATS ratings with their final ED outcome (ie, hospital admission, death or discharge). Results In the two trauma settings, the SATS demonstrated good validity: it accurately predicted an increase in the likelihood of mortality and hospitalisation across incremental acuity levels (p<0.001) and ED outcomes for ‘green’ and ‘red’ patients matched the predicted ED outcomes in 84%–99% of cases. In the mixed ED, the SATS was able to predict an incremental increase in hospitalisation (p<0.001) across both trauma and non-trauma cases. In the paediatric-only settings, SATS was able to predict an incremental increase in hospitalisation in the non-trauma cases only (p<0.001). However, 87% (non-trauma) and 94% (trauma) of ‘red’ patients in the mixed-medical setting were overtriaged and 76% (non-trauma) and 100% (trauma) of ‘green’ patients in the paediatric settings were undertriaged. Conclusion The SATS is a valid tool for trauma-only settings in low-resource countries. Its use in mixed settings seems justified, but context-specific assessments would seem prudent. Finally, in paediatric settings with endemic malaria, adding haemoglobin level to the SATS discriminator list may help to improve the undertriage of patients with malaria.en
dc.language.isoenen
dc.publisherBMJ Publishing Group Ltden
dc.rightsArchived with thanks to BMJ Global Healthen
dc.titleIs the South African Triage Scale Valid for Use in Afghanistan, Haiti and Sierra Leone?en
dc.identifier.journalBMJ Global Healthen
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