Vital signs monitoring critically ill patients in traditional triage: room for improvement and innovation

Mohammad Reza  Kardan; Mehdi  Torabi; Amin  Saberinia; Moghaddameh  Mirzaee

doi:10.18502/fem.v10i1.22030

Mohammad Reza Kardan Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Mehdi Torabi Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Amin Saberinia Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Moghaddameh Mirzaee Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

DOI: https://doi.org/10.18502/fem.v10i1.22030

Keywords: Mortality; Oxygen Saturation; Triage; Vital Signs

Abstract

Objective: In traditional triage, there is often a challenge in accurately assessing the severity of a patient's condition, which can result in under-triage or over-triage. The purpose of this study is to compare traditional and innovative vital signs in predicting possible mortality in critically ill patients.

Methods: This is a cross-sectional study conducted over a three-month period. Patients presenting emergency severity index (ESI) level 1 and 2 triage were divided into two groups: those with and without mortality. Subsequently, the role of traditional triage vital signs [blood pressure, heart rate, oxygen saturation (SpO2), mean arterial pressure (MAP), pulse pressure (PP)] was compared with that of innovative vital signs [shock index (SI), reverse shock index (RSI), modified shock index (MSI), age-shock index (ASI)] in predicting mortality in two groups.

Results: A total of 360 patients were included in the study. A statistically significant association was observed between all innovative and traditional vital signs (with the exception of heart rate) and mortality. In logistic regression, the univariate model revealed a significant association between age, triage level, innovative and traditional vital signs with the occurrence of mortality. In the multivariate model, only MAP, PP, SI, RSI×SpO2, and ASI were found to have a significant association with mortality.

Conclusion: The combination of innovative and traditional vital signs, including MAP, PP, SI, MSI, RSI×SpO2, and ASI in triage may be capable of predicting critically ill patients with a higher probability of mortality.