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Validation of the Cipto Triage Method: A Single-Centre Study from Indonesia

机译：验证CIPTO分类方法：来自印度尼西亚的单一中心研究

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Purpose: A national referral hospital in Indonesia developed a three-category triage acuity method called the Cipto Triage Method (CTM) for emergency departments (ED) in developing countries. This was a validation study to assess the performance of the triage method. Methods: This cohort, retrospective, single-centre study was conducted in the ED of Cipto Mangunkusumo Hospital that receives approximately 30,000 patient visits per year. The ED medical records throughout the year 2017 were randomly selected as the study sample. Completely written forms of triage and ED initial assessment were included in this study. Validation of the CTM decision was done by using expert panel opinion as reference standard, and also using surrogate conditions such as patient outcome for hospital admission and in-hospital mortality. Results: There were 1348 samples assigned to the following three categories: resuscitation (14.9%), urgent (63.8%) and non-urgent (21.3%). Overall accuracy was more than 80%, positive predictive value and negative predictive value for resuscitation category were 99% (95% confidence interval [CI], 96.5– 99.9) and 96.9% (95% CI, 95.7? 97.8), respectively. Resuscitation category had a relative risk (RR) for admission of 1.341 (95% CI, 1.259– 1.429) and a RR for mortality of 4.294 (95% CI, 3.180– 5.799). Undertriage increases the risk of mortality compared to correct triage (RR, 3.1; 95% CI, 2.11– 4.54). Conclusion: CTM has a good criterion and construct validity; it is also easy to understand and can accommodate a simple ED design in the majority of hospitals in Indonesia.
机译：目的：印度尼西亚国家推荐医院开发了一种三类分类，称为CIPTO TRIGE方法（CTM），用于发展中国家的急诊部门（ED）。这是评估分类方法的验证研究。方法：该队列，回顾性，单中心研究是在CIPTO Mangunkusumo医院的ED中进行，每年接受大约30,000名患者访问。在2017年全年的ED医疗记录被随机选择作为研究样本。本研究纳入完全书面的分类和ED初始评估。通过使用专家面板舆论作为参考标准，以及使用患者结果，即住院入住和住院死亡率等替代条件，验证CTM决策。结果：有1348个样本分配到以下三类：复苏（14.9％），紧急（63.8％）和非紧急（21.3％）。整体准确性超过80％，复苏类别的阳性预测值和负预测值分别为99％（95％置信区间[CI]，96.5-99.9）和96.9％（95％CI，95.7？97.8）。复苏类别具有相对风险（RR），用于预处理1.341（95％CI，1.259-1.429）和4.294的死亡率（95％CI，3.180-5.799）。与校正分类（RR，3.1; 95％CI，2.11- 4.54）相比，下疗会增加死亡率的风险。结论：CTM具有良好的标准和构建有效性;它也很容易理解，可以在印度尼西亚大多数医院提供简单的设计。

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