Association of the Charlson index with risk classification, clinical aspects, and emergency outcomes.
Ana Paula Santos de Jesus, Meiry Fernanda Pinto Okuno, Cassia Regina Vancini Campanharo and 2 others
PMID 35080236WHAT IT FOUND
In 3,624 emergency records, higher age-adjusted comorbidity scores were associated with red and white triage, vascular, endocrine, neurologic, cardiac complaints, head tomography, and admission, transfer, or death.
It flags risk but does not prove triage should change.
Key findings
01Higher mean age-adjusted Charlson scores were seen in the red and white Manchester Triage System risk categories than in orange, yellow, green, and blue.
02A high age-adjusted Charlson score, greater than 2, was present in 26.1% of the sample.
03Mean age-adjusted Charlson scores were higher for hospital admission, transfer, and death than for discharge, and those scores were greater than 2.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It was a single-center study, so results may not apply to other emergency departments. It used paper medical records, so missing or illegible entries were possible; 533 records were excluded for missing risk classification. It was cross-sectional and chart-based, so it shows association, not that comorbidity score caused worse triage or outcomes. The age-adjusted Charlson index was not validated for use with the Manchester Triage System in this setting. The white category included scheduled or specialist referral patients from a high-complexity reference hospital, so high scores there may reflect hospital case mix rather than acute emergency severity.
Declared interests
The study was supported by CAPES, Brazil, financing code 001. No other conflicts are stated.
The easy way to misread this
Do not conclude that adding the age-adjusted Charlson score to Manchester triage will improve patient safety or predict death. This study used existing records and found associations only; it did not test the score prospectively or prove that it should change triage decisions.