Factors Influencing Mistriage Based on the Korean Triage and Acuity Scale: A Retrospective Cross-Sectional Study.
Nayeon Yi, Dain Baik
PMID 40619607WHAT IT FOUND
Emergency nurses using the Korean Triage and Acuity Scale misclassified adult ED patients, with under-triage linked to low blood pressure and fever, and over-triage to pain, younger age, and less triage experience.
Key findings
01Among 1110 adult ED patients, ED nurses correctly classified 903 (81.4%) and misclassified 207 (18.6%), with under-triage 88 (7.9%) and over-triage 119 (10.7%).
02Under-triage was associated with mean arterial pressure below 65 mmHg (5.42 times compared with 65 mmHg or higher) and with immunity or fever complaints (3.41 times compared with neurological complaints).
03Over-triage was associated with pain (1.96 times compared with no pain) and with less than 2 years of KTAS experience (1.95 times compared with more than 3 years).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Single-center retrospective record review at one urban academic hospital, so rates may not apply to other EDs. The study could not capture real-time triage cues such as the critical first look or patient conversation. Some key variables were missing for 7 patients and were excluded from regression; sPO2 was not measured for all patients. Associations were cross-sectional and cannot prove that age, pain, low MAP, complaints, or experience caused mistriage. Final levels were assigned by experts after the fact, which may differ from decisions made in a crowded ED.
Declared interests
The authors declare no conflicts of interest. The provided text does not state a funding source.
The easy way to misread this
Do not read the reported factors as causes of mistriage. This was a single-center retrospective record review comparing initial triage levels with expert adjudicated final levels, so it shows associations in one setting, not proof that pain, low blood pressure, fever, age, or less experience caused the errors.