BACKGROUND: Overtriage has been observed among @entity4806 @entity1 in emergency departments (EDs) under 5-level acuity @entity4806 triage systems. This study aimed to investigate the causes of overtriage and to provide suggestions for future amendments to such systems. METHODS: This study has a retrospective follow-up design in which 42000 @entity4806 @entity1 who were admitted to the @entity2613 of the largest medical center in Taiwan between January and December of 2010 were recruited. The study variables included @entity1 demographics, chief concerns, individual vital signs (ie, blood pressure, heart rate, body temperature, respiratory rate, and O2 saturation), triage level, @entity2613 final disposition, @entity2613 expenses, and total medical expenses. A logistic regression model was applied to explore the causes of overtriage and the effectiveness of a modified acuity system. RESULTS: Approximately 13.6% of the @entity4806 @entity2613 visits were upgraded to acuity level 1 based on vital signs that included heart rate (97.3%). The strength of the trend association (odds ratio) between decreasing acuity urgency (from levels 1 to 5) and hospitalization increased from 0.73 (95% confidence interval, 0.72-0.75) with the Pediatric Triage and Acuity System (Ped-TTAS) to 0.57 (95% confidence interval, 0.55-0.59) with the modified Ped-TTAS, which downgraded acuity levels by excluding the weighting of vital signs. Further validation was accomplished by comparing the trend association between decreasing acuity urgency and total medical expenses (Ped-TTAS: b = -0.13; modified Ped-TTAS: b = -0.18). CONCLUSIONS: Heart rate is prone to be affected by emotional responses among @entity4806 @entity1 in certain specific age groups. Appropriate revisions of the @entity4806 triage system are suggested.

Pediatric overtriage as a consequence of the tachycardia responses of @entity1 upon XXXX admission.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity4806 :: ('MESH:D063766', 'Disease') :: ['pediatric'] @entity2613 :: ('MESH:C536181', 'Disease') :: ['ED']
@entity2613 :: (MESH:C536181,Disease) :: ['ED']
