Prediction of Emergent Heart Failure Death by Semi-Quantitative Triage Risk Stratification
2011

Predicting Early Death in Heart Failure Patients Using Triage Risk Assessment

Sample size: 68380 publication 10 minutes Evidence: high

Author Information

Author(s): Van Spall Harriette G. C., Atzema Clare, Schull Michael J., Newton Gary E., Mak Susanna, Chong Alice, Tu Jack V., Stukel Thérèse A., Lee Douglas S.

Primary Institution: Population Health Research Institute, Hamilton Health Science and McMaster University

Hypothesis

Can the Canadian Triage Acuity Scale (CTAS) predict early mortality among patients with acute heart failure in the emergency department?

Conclusion

The CTAS effectively predicts emergent death among heart failure patients in the emergency department.

Supporting Evidence

  • The CTAS score had high discrimination for deaths occurring in the ED or within 1 day of presentation.
  • Patients with CTAS 1 had a 9.06 times higher risk of 1-day mortality compared to lower acuity patients.
  • The study included a large cohort of 68,380 heart failure patients.

Takeaway

Doctors can use a simple scoring system to figure out how likely it is that heart failure patients will get very sick or die soon after they come to the hospital.

Methodology

Retrospective cohort analysis of patients presenting with heart failure to emergency departments in Ontario from April 2003 to March 2007.

Potential Biases

Subjectivity in triage assessments may lead to less objective prognosis estimates.

Limitations

The study could not account for the quality of care provided in the ED, and it focused primarily on symptomatic pulmonary congestion.

Participant Demographics

Mean age 76 years, 49.4% men.

Statistical Information

P-Value

p<0.001

Confidence Interval

95%CI; 0.93–1.88

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1371/journal.pone.0023065

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