The Emergency Severity Index is a 5-level triage measure used in urgency rooms to determine the severity of the emergency and the demand for resources. It was uncertain, nevertheless, if it was true for patients older than or equivalent to 65. For a study, researchers examined the Emergency Severity Index triage system’s accuracy for emergency department patients between the ages of 18 and 64 and those older than or equal to 65.

The study examined persons who visited a Finnish emergency room between February 1 and February 28, 2018. It was a retrospective observational cohort study. All information was gathered from computerized medical records.

Around 3-day mortality was the main result. About 30-day mortality, hospital admission, high dependency unit or ICU admission, and duration of stay in the emergency department were the secondary outcomes. To look into significant correlations between triage categories and outcomes, cutoff performances and the area under the receiver operating characteristic curve were employed. They compared the outcomes of the 2 age groups.

There were 2,370 patients over the age of 65 and 3,141 patients between the ages of 18 and 64 in the emergency room. Patients older than or equal to 65 years had a larger area under the 3-day mortality curve than patients between the ages of 18 and 64. In all categories, the Emergency Severity Index was somewhat sensitively related to high dependency unit/ICU admissions [18-64 years: 61.8% (50.9-71.9%); greater than or equal to 65 years: 73.3% (63.5-81.6%)]  and high specificity [18–64 years: 93.0% (92.0–93.8%); greater than or equal to 65 years: 90.9% (90.0–92.1%)]. In both age categories, hospital admission and 30-day mortality had good sensitivity and low specificity. For both age groups, category 3 of the Emergency Severity Index had the greatest length of stay in the emergency room. For any outcome, there was no discernible difference in the accuracy between age groups for any outcome.

The Emergency Severity Index fared well in predicting the rates of high dependency unit/ICU admission for patients aged 18 to 64 and those aged 65 or older. For patients older than or equal to 65 years, it accurately predicted the 3-day mortality. It proved ineffective in predicting 30-day mortality and hospital admission for both age groups.

Reference: journals.lww.com/euro-emergencymed/Fulltext/2022/06000/Accuracy_of_Emergency_Severity_Index_in_older.9.aspx