Journal article
Predictive Value of Initial Triage Vital Signs for Critically Ill Older Adults
The western journal of emergency medicine, v 14(5), pp 453-460
01 Sep 2013
PMID: 24106542
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Introduction: Triage of patients is critical to patient safety, yet no clear information exists as to the utility of initial vital signs in identifying critically ill older emergency department (ED) patients. The objective of this study is to evaluate a set of initial vital sign thresholds as predictors of severe illness and injury among older adults presenting to the ED.
Methods: We reviewed all visits by patients aged 75 and older seen during 2007 at an academic ED serving a large community of older adults. Patients' charts were abstracted for demographic and clinical information including vital signs, via automated electronic methods. We used bivariate analysis to investigate the relationship between vital sign abnormalities and severe illness or injury, defined as intensive care unit (ICU) admission or ED death. In addition, we calculated likelihood ratios for normal and abnormal vital signs in predicting severe illness or injury.
Results: 4,873 visits by patients aged 75 and above were made to the ED during 2007, and of these 3,848 had a complete set of triage vital signs. For these elderly patients, the sensitivity and specificity of an abnormal vital sign taken at triage for predicting death or admission to an ICU were 73% (66,81) and 50% (48,52) respectively (positive likelihood ratio 1.47 (1.30,1.60); negative likelihood ratio 0.54 (0.30,0.60).
Conclusion: Emergency provider assessment and triage scores that rely primarily on initial vital signs are likely to miss a substantial portion of critically ill older adults.
Metrics
Details
- Title
- Predictive Value of Initial Triage Vital Signs for Critically Ill Older Adults
- Creators
- Michael A. LaMantia - Indiana UniversityPaul W. Stewart - Biostat (United States)Timothy F. Platts-Mills - College Station Medical CenterKevin J. Biese - College Station Medical CenterCory Forbach - College Station Medical CenterEzequiel Zamora - College Station Medical CenterBrenda K. McCall - Univ North Carolina Hosp, Chapel Hill, NC USAFrances S. Shofer - College Station Medical CenterCharles B. Cairns - College Station Medical CenterJan Busby-Whitehead - Univ N Carolina, Div Geriatr, Chapel Hill, NC 27515 USAJohn S. Kizer - Univ N Carolina, Div Geriatr, Chapel Hill, NC 27515 USA
- Publication Details
- The western journal of emergency medicine, v 14(5), pp 453-460
- Publisher
- Westjem
- Number of pages
- 8
- Grant note
- K23AG038548 / NATIONAL INSTITUTE ON AGING; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA) K23 AG038548 / NIA NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000422601800016
- Scopus ID
- 2-s2.0-84888363898
- Other Identifier
- 991021448023204721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Emergency Medicine