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Cited by 326Emergency and Acute Care StudiesTrauma and Emergency Care StudiesSepsis Diagnosis and Treatment

The DOI matches its Crossref record; 20 of the 20 references it cites were found in a registry or an index.

Reliability and Validity of Scores on the Emergency Severity Index Version 3

Tanabe, Paula, Gimbel, Rick, Yarnold, Paul R., Kyriacou, Demetrios N., Adams, James G.·2004·Academic Emergency Medicine
DOI 10.1197/j.aem.2003.06.013
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Abstract

OBJECTIVES: No widely used triage instrument accurately assesses patient acuity. The Emergency Severity Index (ESI) promises to facilitate reliable acuity assessment and possibly predict patient disposition. However, reliability and validity of ESI scores have not been established in emergency departments (EDs) outside the original research sites, and version 3 (v.3) of the ESI has not been evaluated. The study hypothesis was that scores on the ESI v.3 show good interrater reliability and predict hospital admission, admission site, and death. METHODS: The authors conducted an ED-based cross-sectional retrospective study of 403 systematically selected ED records of patients who presented to an academic medical center. Twenty-seven variables were abstracted, including triage level assigned, admission status, site, and death. Using a standard process, the researchers determined the true triage level. Weighted kappa and Pearson correlation were used to calculate interrater reliability between true triage level and triage score assigned by the registered nurse (RN). The relationships between the true ESI level and admission, admission site, and death were assessed. RESULTS: Interrater reliability between RN ESI level and the true ESI level was kappa = 0.89; Pearson r = 0.83 (p < 0.001). Hospital admission by ESI level was as follows: 1 (80%), 2 (73%), 3 (51%), 4 (6%), and 5 (5%). A higher percentage of ESI level-1 and level-2 patients (40%, 12%) were admitted to the intensive care unit than ESI levels 3-5 (2%, 0%, 0%). Admission to telemetry for ESI levels 1-5 was 20%, 19%, 7%, 1%, and 0%, respectively. Three of four patients who died were ESI level 1 or 2. CONCLUSIONS: Scores on the ESI assigned by nurses have excellent interrater reliability and predict hospital admission and location of admission.

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Research works printed but not linked: 4

  1. McCaig L, 2002, Division of Health Care Statistics, Centers for Disease Control. National Hospital Ambulatory Medical Care Survey: 2000 Emergency Department Survey, Advance Data from vital and health statistics., 326, 1
  2. Emergency Nurses Association, 2001, Triage: Making the Right Decision: A Triage Curriculum
  3. Emergency Nurses Association, 1996, National Emergency Department Database Survey
  4. Emergency Nurses Association, 1998, Triage: Meeting the Challenge

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Metadata

Authors
Tanabe, P., Gimbel, R., Yarnold, P. R., Kyriacou, D. N., & Adams, J. G.
Affiliations
Northwestern University (US)
ORCID
Venue
Academic Emergency Medicine
Publisher
Wiley
Published
2004-01
Volume
11
Issue
1
Pages
59-65
ISSN
  • 1069-6563 (ISSN-L)
  • 1553-2712
DOI
10.1197/j.aem.2003.06.013
OpenAlex
W1995360315
Cited by
326
References
20
Citations by year
2026: 10 · 2025: 4 · 2024: 8 · 2023: 13 · 2022: 12 · 2021: 17 · 2020: 24 · 2019: 21 · 2018: 15 · 2017: 18 · 2016: 15 · 2015: 20 · 2014: 10 · 2013: 21 · 2012: 15
FWCI
14.07
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 1468 d)
Locations
  • Academic Emergency Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
  • Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
Keywords
Emergency Severity Index, emergency department triage, patient acuity assessment, inter-rater reliability, validity, hospital admission prediction, patient disposition, mortality prediction, nurse triage
MeSH terms
Adult, Aged, Algorithms, Cross-Sectional Studies, Emergencies, Emergency Service, Hospital, Female, Hospitals, Urban, Humans, Male, Medical Records, Middle Aged, Nursing Assessment, Nursing Staff, Hospital, Outcome and Process Assessment, Health Care, Patient Admission, Severity of Illness Index, Triage, United States, Emergency Nursing, Hospital Mortality

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