{"id":28354,"date":"2025-07-09T04:54:00","date_gmt":"2025-07-08T20:54:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=28354"},"modified":"2025-07-09T06:35:18","modified_gmt":"2025-07-08T22:35:18","slug":"jama-netw-open%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%80%a5%e8%af%8a%e7%a7%91%e9%92%88%e5%af%b9%e9%ab%98%e5%8d%b1%e6%83%85%e5%86%b5%e7%9a%84%e5%88%86%e8%af%8a%e5%87%86%e7%a1%ae%e6%80%a7","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=28354","title":{"rendered":"[JAMA Netw Open\u53d1\u8868\u8bba\u6587]\uff1a\u6025\u8bca\u79d1\u9488\u5bf9\u9ad8\u5371\u60c5\u51b5\u7684\u5206\u8bca\u51c6\u786e\u6027\u4e0e\u6cbb\u7597\u5ef6\u8bef"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Emergency Medicine<\/p>\n\n\n\n

May 2, 2025<\/p>\n\n\n\n

Emergency Department Triage Accuracy and Delays in Care for High-Risk Conditions<\/h1>\n\n\n\n

Dana R. Sax, E. Margaret Warton, Dustin G. Mark, et al<\/h3>\n\n\n\n

JAMA Netw Open. <\/em>2025;8(5):e258498. doi:10.1001\/jamanetworkopen.2025.8498<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  Is there an association between emergency department (ED) triage accuracy and timeliness of care among patients with subarachnoid hemorrhage (SAH), aortic dissection (AD), or ST elevation myocardial infarction (STEMI)?<\/p>\n\n\n\n

Findings<\/strong>  In this cohort study including 5929 patients, undertriage was associated with delayed computed tomography orders by 2.4 minutes for patients with SAH and by 8.9 minutes for patients with AD and delayed medication orders by 33.3 minutes for patients with AD and 17.6 minutes for patients with SAH. Differences in time to electrocardiogram and troponin orders were not statistically significant for undertriaged vs correctly triaged patients with STEMI.<\/p>\n\n\n\n

Meaning<\/strong>  These findings suggest undertriaged patients are more likely to experience delays for certain high-risk ED conditions but that consistent and rapid electrocardiogram completion for patients with STEMI likely overrides triage accuracy for these patients.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Emergency department (ED) triage may impact timeliness of care for high-risk conditions.<\/p>\n\n\n\n

Objective<\/strong>  To determine the association of ED undertriage with delays in care for patients with subarachnoid hemorrhage (SAH), aortic dissection (AD), and ST-elevation myocardial infarction (STEMI).<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This retrospective cohort study included adult ED patients diagnosed with SAH, AD, or STEMI from January 1, 2016, to December 31, 2020, from a multicenter, community-based health care delivery system. Data analysis were completed in March 2023 to October 2024.<\/p>\n\n\n\n

Exposure<\/strong>  Undertriage vs correct triage, defined by operational measures of mistriage.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  Using a lognormal distribution, the outcomes of interest for patients with SAH and AD were adjusted median time to noncontrast computed tomography (CT) (head CT for patients with SAH, chest CT for patients with AD), antihypertensive medication orders (SAH), and \u03b2-blocker orders (AD), and ED length of stay (LOS). For patients with STEMI, outcomes of interest were adjusted median time to electrocardiogram (ECG) and troponin orders.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0A total of 5929 patients (median [IQR] age, 63.0 [54.0 to 73.0] years; 3876 [65.4%] male) were identified, including 915 with SAH, 480 with AD, and 4534 with STEMI. There were 1129 Asian patients (19.0%), 553 Black patients (9.3%), 889 Hispanic patients (15.0%), and 2906 non-Hispanic White patients (49.0%). Overall, 2175 patients (36.7%) were undertriaged. For patients with SAH, the lognormal estimate for delay in time to head CT was 0.2 (95% CI, 0.0-0.3), or a delay of 2.4 minutes, and for antihypertensive orders, the lognormal estimate was 4.8 (95% CI, 3.6-5.9), or a delay of 33.3 minutes; the lognormal estimate for ED LOS was 0.1 (95% CI, 0.0-0.1), or 7.7 minutes longer. For patients with AD, the lognormal estimate for delays were 0.2 (95% CI, 0.0-0.4), or 8.9 minutes, for chest CT and 0.5 (95% CI, 0.2-0.7), or 17.6 minutes, for \u03b2-blocker orders, and ED LOS was 0.2 (95% CI, 0.1-0.3), or 64 minutes longer. For patients with STEMI, differences in time to ECG and troponin orders were not statistically significant, at less than 1 minute, comparing correctly and undertriaged patients.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  In this cohort study of patients diagnosed with SAH, AD, or STEMI, ED undertriage was associated with small but significant delays in key diagnostic and therapeutic orders for patients with SAH and AD but not for patients with STEMI.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Emergency Medicine May&nbs […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28354"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=28354"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28354\/revisions"}],"predecessor-version":[{"id":28691,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28354\/revisions\/28691"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=28354"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=28354"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=28354"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}