RT Journal Article
SR Electronic
T1 Is the South African Triage Scale valid for use in Afghanistan, Haiti and Sierra Leone?
JF BMJ Global Health
FD BMJ Publishing Group Ltd
SP e000160
DO 10.1136/bmjgh-2016-000160
VO 2
IS 2
A1 Mohammed Dalwai
A1 Pola Valles
A1 Michele Twomey
A1 Yvonne Nzomukunda
A1 Prince Jonjo
A1 Manoj Sasikumar
A1 Masood Nasim
A1 Abdul Razaaq
A1 Olivia Gayraud
A1 Pierre Ronald Jecrois
A1 Lee Wallis
A1 Katie Tayler-Smith
YR 2017
UL http://gh.bmj.com/content/2/2/e000160.abstract
AB 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.