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Background: The performance of the Quick Sequential Organ Failure Assessment (qSOFA) score needs to be explored further in the emergency triage room. This study aims to explore the performance of triage (tqSOFA) versus the dichotomized triage score (DTS) in patients admitted to the emergency room triage with fever., Methods: This research was designed as a prospective, observational study within a six-month period, including patients who presented to the emergency room triage with infrared fever ≥ 37.5 °C., Results: 771 patients were analyzed.The highest sensitivity for predicting overall hospitalization and intensive care admission was seen for DTS (95.4 %, 100 %; p < 0.0001, p < 0.0001, respectively) (AUC:0.697, 95 % CI 0.663 to 0.730; AUC:0.684, 95 % CI 0.650 to 0.717, respectively). The highest sensitivity for predicting 1st week and 1st month mortality was found for DTS (100 %, 96.3 %; p < 0.0001, p < 0.0001, respectively). However, the highest specificity for predicting 1st week and 1st month mortality was observed in tqSOFA (94.1 %, 95.16; p = 0.0845, p < 0.0001, respectively) (AUC:0.658, 95 % CI 0.623 to 0.691; AUC:0.698, 95 % CI 0.664 to 0.730, respectively)., Conclusion: We found DTS to be as effective as tqSOFA and SIRS in determining all hospitalization times and mortality., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Assessment of nurse triage decision accuracy and triage times is currently carried out through paper-based methods. This quality improvement study aims to develop a method that can assess the accuracy and duration of nurse triage decisions based on a computerized system and to share an example of the application of this method., Methods: This is a descriptive quality improvement study. The study was carried out in two stages between March and May 2019. The functionality of the developed method was examined using 3835 patients' triage data, which were obtained between June 1 and 14, 2019., Results: With this study, the determination of the accuracy and duration of nurse triage decisions was accomplished with a computerized process based on real patient outputs, and the accuracy and duration of these decisions were continuously measured, monitored, and assessed, which is different from paper-based methods. The functionality of the method was evaluated with data from 3835 real patients. The triage decision accuracy rate was 64.4%, and the average duration of triage was 81.3s. Positive feedback on the method was received from all triage nurses., Conclusion: The study result outputs can be integrated into quality processes and can be used internationally as performance assessment criteria and quality indicators for triage nursing., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objective: Critically ill patients have high mortality and admission rates requiring early recognition and a rapid management. In the present study, we evaluated the prognostic parameters in these patients and the value of perfusion index measurement as a novel tool for accomplishing emergency department (ED) triage., Methods: Seven hundred seventy patients admitted to the critical care area of the ED in a month composed the study population. Perfusion index and vital signs (blood pressure, pulse rate, body temperature, pulse oximeter, and respiration rate) of the study patients were recorded to the study form. The communication data, admitting time, comorbidities, capillary refilling time, and blood gas analysis findings if obtained were recorded. Outcome of patients at the end of the ED period such as discharge, admission to the hospital, and death were also recorded. Outcome of patients at 15th and 30th days was identified by telephone call follow-up or from hospital records., Results: Two hundred seventy-eight patients (36.1%) were admitted to the hospital, 454 patients (59%) were discharged, 3 patients (0.4%) died in the ED, 25 patients (3.2%) were transferred to another hospital, and 10 patients (1.3%) refused treatment and left the ED. Sixty patients (7.8%), 39 (5.1%) of whom had died in 15 days' period, were dead at the end of 30-day follow-up period. Respiratory rate and pulse oximetry were significant parameters in hospital admission. Systolic blood pressure, diastolic blood pressure, pulse rate, respiratory rate, pulse oximetry, lactate levels in blood gas analysis, and ED length of stay were significant variables in 30-day mortality rate. Patients who were admitted to the hospital had higher rates of fever and diabetes. Patients who had died in the 30-day follow-up period had higher rates of diabetes and malignancy. In logistic regression analysis, the predictors of hospital admission were hypotension, fever, and pulse oximetry, whereas the predictors of 30-day mortality were systolic blood pressure, respiratory rate, pulse oximetry, and presence of malignancy., Conclusions: Perfusion index as a novel triage instrument was found to be an insignificant tool in predicting hospital admission and mortality of critically ill patients in the ED. However, diabetes and malignancy were found to be independent factors in determining the prognosis of these patients in addition to vital signs and should be considered by ED physicians either in triage field or inside the ED., (Copyright © 2015. Published by Elsevier Inc.)