Triage performance in adolescent patients with SARS-CoV-2 infection in Israel - 04/08/22

Doi : 10.1016/j.ajem.2022.06.061

Nitai Levy, MD ^a, Nir Friedman, MD ^b,^r, Or Kaplan, MD ^c, Gabi Padeh, MD ^d,^r, Danna Krupik, MD ^e, Nachshon Buchshtav, MD ^f, Shirly Gamsu, MD ^g,^r, Giora Weiser, MD ^h, Naama Kuchinski Cohen, MD ⁱ, Zeev Schnapp, MD ^j, Noy Cohen, MD ^k, Jordanna H. Koppel, MD ^l,^r, Danit Porat, MD ^m,^r, Moran Gal, MD ⁿ, Alexandra Gleyzer, MD ^o, Tali Capua, MD ^p,^r, Irena Chistyakov, MD ^q, Itai Shavit, MD ^a,^{^⁎}
^a Pediatric Emergency Department, Rambam Health Care Campus, Haifa, Israel
^b Pediatric Emergency Department, Meir Medical Center, Kfar Saba, Israel
^c Pediatric Emergency Department, Soroka Medical Center, Beer Sheva, Israel
^d Emergency Department, Schneider Children's Medical Center, Petah Tikva, Israel
^e Pediatric Emergency Department, Ziv Medical Center, Safed, Israel
^f Pediatric Emergency Department, Ha'Emek Medical Center, Afula, Israel
^g Pediatric Emergency Department, Shamir Medical Center (Assaf Harofeh), Beer Yaakov, Israel
^h Pediatric Emergency Department, Shaare Zedek Medical Center, Jerusalem, Israel
ⁱ Pediatric Emergency Department, Hillel Yaffe Medical Center, Hadera, Israel
^j Pediatric Emergency Department, Carmel Medical Center, Haifa, Israel
^k Pediatric Emergency Department, Samson Assuta University Hospital, Ashdod, Israel
^l Pediatric Emergency Department, Sheba Medical Center, Tel Hashomer, Israel
^m Pediatric Emergency Department, Wolfson Medical Center, Holon, Israel
ⁿ Pediatric Emergency Department, Kaplan Medical Center, Rehovot, Israel
^o Pediatric Emergency Department, Mayanei Hayeshua Medical Center, Bnei Brak, Israel
^p Pediatric Emergency Department, Sourasky Medical Center, Tel Aviv, Israel
^q Pediatric Emergency Department, Bnai Zion Medical Center, Haifa, Israel
^r Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

^⁎Corresponding author at: POB 274, Kibbutz Maayan Tzvi 3080500, Israel.Israel

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Abstract

Objective

The aim of this study was to assess the performance of the Pediatric Canadian Triage and Acuity Scale (PaedCTAS) in adolescent patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Methods

A time-series study was conducted in the Emergency Departments (EDs) of 17 public hospitals during the Delta (B.1.617.2) variant spread in Israel. Data were collected prospectively from June 11, 2021 to August 15, 2021. Multivariate regression analyses were performed to identify independent variables associated with hospital admission and with admission to an Intensive Care Unit (ICU).

Results

During the study period, 305 SARS-CoV-2 patients ages 12–18 years presenting to the ED were included, and 267 (87.5%) were unvaccinated. Sixty-seven (22.0%) and 12 (3.9%) patients were admitted to pediatric wards and ICUs, respectively. PaedCTAS level 1–2 and the presence of chronic disease increased the odds of hospital admission (adjusted odds ratio (aOR) 5.74, 95% CI, 2.30–14.35, p < 0.0001), and (aOR 2.9, 95% CI, 1.48–5.67, p < 0.02), respectively. PaedCTAS level 1–2 and respiratory symptoms on presentation to ED increased the odds of ICU admission (aOR 27.79; 95% CI, 3.85–176.91, p < 0.001), and (aOR 26.10; 95% CI, 4.47–172.63, p < 0.0001), respectively. PaedCTAS level 3–5 was found in 217/226 (96%) of the patients who were discharged home from the ED.

Conclusions

The findings suggest that PaedCTAS level 1–2 was the strongest factor associated with hospital and ICU admission. Almost all the patients who were discharged home had PaedCTAS level 3–5. Study findings suggest good performance of the PaedCTAS in this cohort.

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Keywords : Adolescent, Triage, SARS-CoV-2, COVID-19, PaedCTAS

Abbreviations : SARS-CoV-2, ED, RT-PCR, PedCTAS

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Introduction

Methods

Study design and participants

Pediatric ED triage in Israel

Statistical analysis

Results

Discussion

Contributors' statement

Access to data

Financial disclosure

Conflict of interest

Competing interests and funding

Ethics committee approval

CRediT authorship contribution statement

Esportazione

Vol 59

P. 70-73 - Settembre 2022 Ritorno al numero

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Triage performance in adolescent patients with SARS-CoV-2 infection in Israel - 04/08/22

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Methods

Results

Conclusions

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