The Prediction Model of Elderly Patients in Taiwan Triage and Acuity Scale

The Analysis of Prediction Model of Elderly Patients Visiting Emergency Department in Taiwan Triage and Acuity Scale

In the year of 2010, the Taiwan Ministry of Health and Welfare had implemented the 5-level Taiwan Triage and Acuity Scale(TTAS) in Taiwan emergency department. TTAS is a triage system that was modified from CTAS. It has a comprehensive chief complaint system and accomplished with an electronic decision support system (eTTAS) to help triage nurse to assign acuity level on emergency patients in emergency departments of Taiwan. TTAS has adult and children modifiers, but no modifier for the elderly. In emergency departments, the geriatric population have been increasing in many countries for the last few years. They often present with atypical symptoms or signs, and multiple comorbidities that complicate diagnosis and treatment and are at risk of under-triage. Although the TTAS has overall validity and reliability, its performance in geriatric patients has not been well studied.

In order to reduce the chance to under-triage the geriatric patients in emergency departments and to improve the discriminatory and predictive power for triaged patients who require admission, the objective of the study is to examine the difference of urgency, admission rate and medical resource consumption of geriatric patients with different age group compared to non-geriatric patients, to develop predictive model for hospitalization and medical resource consumption among geriatric patients and to develop special geriatric modifiers.

Study Overview

• Status: Unknown
• Conditions: Frail Elderly Syndrome; Triage

Detailed Description

Age and frailty have been demonstrated to be associated with clinical outcomes in the elderly presented to emergent departments (EDs). This study aimed to assess the association of age and frailty on admission rate and to find out whether the current Taiwan Triage and Acuity Scale (TTAS) under-triage elderly presented to EDs.

This was a retrospective cohort study that reviewed medical records of adult patients from a single ED from 2016 to 2017. Data collected included patients' demographics, TTAS level, chief complaints, frailty status, and intensive care unit (ICU) admission rate. Adults patients included in the study were divided into three age groups of 18-<65, 65-85, and >85 years.

• Study Type: Observational
• Enrollment (Anticipated): 1000

Contacts and Locations

Study Locations

• Taiwan
  • Taoyuan, Taiwan, 333
    • Chang Gung Memorial Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients over 65 years old who go to the emergency department.

Description

Inclusion Criteria:

• Patients over 65 years old who go to the emergency department.
• Those who are willing to participate in the trial and sign a consent form and are willing to be tracked.

Exclusion Criteria:

• Patients under 65 years old who go to the emergency department.
• Patients over 65 years old who go to the emergency department, unwilling to participate in the trial and sign the consent.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
admission rate	1 day (since patient come into ER until he leave from ER.)
frailty scale	1 day (since patient come into ER until he leave from ER.)

Collaborators and Investigators

• Sponsor: Chang Gung Memorial Hospital
• Collaborators: Changhua Christian Hospital; Taipei City Hospital
• Investigators: Principal Investigator: Chip Jin Ng, Dr., Chang Gung Memorial Hospital; Study Director: Tsung Hsien Chao, Dr., Chang Gung Memorial Hospital; Study Chair: Cheng Yu Chien, Dr., Chang Gung Memorial Hospital

Study record dates

Study Major Dates

• Study Start (Actual): January 31, 2020
• Primary Completion (Anticipated): July 31, 2021
• Study Completion (Anticipated): July 31, 2021

Study Registration Dates

• First Submitted: April 26, 2021
• First Submitted That Met QC Criteria: April 27, 2021
• First Posted (Actual): April 28, 2021

Study Record Updates

• Last Update Posted (Actual): April 28, 2021
• Last Update Submitted That Met QC Criteria: April 27, 2021
• Last Verified: January 1, 2021

More Information

Terms related to this study

• Keywords: Frailty; Triage; Geriatric
• Other Study ID Numbers: 202000012B0C502

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data that support the findings of this study are available from the first author on reasonable request.including
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ANALYTIC_CODE; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No