[The prediction of hospitalization in triage: a comparison of instruments and methods of evaluation. A systematic revision].

Unlabelled: . The prediction fo Hospitalization in triage: a comparison of instruments and methods of evaluation. A systematic revision.

Introduction: Overcrowding in the emergency department causes called-boarding, in addition to the increase of the waiting times, high costs and unsatisfied patients. Boarded patients are those admitted to an inpatient unit in the hospital that continue to wait in the emergency department for a bed to become available. The adoption of tools and methods to help the clinician to predict the admission in the triage phase could significantly improve patients flow.

Aim: To analyze and compare different tools and methods and to predict the hospitalization in the triage phase for adult patients.

Methods: A systematic review was conducted by querying the PubMed and Cochrane databases, limited to the last 10 years articles.

Results: Ten longitudinal observational studies analyzed the variables associated with admission, predictive ability of the clinical judgment of the triage nurse, predictive ability of validated objective scores, and cross compared the various methods of predicting admission. The variable most associated with admission was advanced age; both the clinical judgment of the triage nurse and the various scores showed a good predictive ability; the association of the clinical judgment of the triage nurse with one of the scores would offer more accurate predictions.

Discussion: The ability to predict admission in the triage, through the use of validated scores and the clinical judgment of the triage nurse, could be the first step to reduce the boarding phenomenon and to improve the flow in the emergency department.