Coverage and Appropriateness of the Taiwan Adult Triage Complaint List

台灣成人急診檢傷分級表主訴的涵蓋率與適切性

李景行(Ching-Hsing Lee) ； 管仁澤(Jen-Tse Kuan) ； 邱德發(Te-Fa Chiu) ； 司麗雲(Li-Yun Szu) ； 陳麗琴(Li-Chin Chen) ； 陳日昌(Jih-Chang Chen) ； 黃集仁(Chip-Jin Ng)

《Journal of Emergency Medicine, Taiwan》 9卷3期 (2007/09) Pp. 65-71

摘要

目的：研究成人急診病患檢傷主訴由臺灣檢傷分類概要分級表Taiwan Triage System(TTS)分類的涵蓋率與完整性。
方法：收集2004年1月某醫療體系四家醫院成人急診病患的檢傷主訴，分別以臺灣急診檢傷主訴分級表與加拿大檢傷主訴表Canadian Emergency Department Information System (CEDIS) complaint list分類，比較兩者的涵蓋率；並針對未使用的臺灣檢傷主訴進行討論。
結果：24472位病患主訴中，可由國內檢傷分級表歸類者佔43.06%，其中內科可分類病患占內科總病患的40.96%，外科可分類病患占外科總病患的58.78%；涵蓋率不足原因為，(1)部份項目為診斷而非主訴；(2)五官科主訴無法歸類；(3)未涵蓋各器官系統常見急診主訴。以加拿大檢傷分級主訴歸類，可分類者佔98.72%，較國內分級增加55.66%。
結論：目前國內急診檢傷分級主訴不足以涵蓋大部份的病患主訴，以加拿大急診檢傷分級主訴可以增加主訴涵蓋率，可考慮引進國外檢傷分級主訴或發展新的分類系統。

關鍵字

主訴 ； 檢傷 ； 臺灣檢傷分類概要分級表 ； 加拿大檢傷主訴表

並列摘要

Background: Our purpose was to evaluate the coverage and comprehensiveness of the Taiwan Triage System (TTS) adult complaint list.
Method: We retrospectively collected all triage chief complaints of adult patients admitted to the emergency departments of 4 hospitals in one medical system in January 2004. Their complaints were classified according to the TTS adult complaint list and the Canadian Emergency Department Information System (CEDIS) complaint list. The percentages of complaints classified by each system were calculated to compare their coverage. Those complaints that could not be classified by the TTS adult complaint list were reorganized according to the CEDIS complaint list categories. The criteria which were not used in the Taiwan system were also analyzed for their appropriateness.
Results: There were 24472 complaints enrolled in our study. The TTS adult complaint list only covered and classified 43.06% of all complaints, 40.96% of non-trauma complaints, and 58.78% of trauma complaints. The TTS adult complaint list was inappropriate and not comprehensive for the following reasons: (1) Some criteria on the list were diagnoses instead of complaints (2) Ophthalmic, otorhinolaryngologic, and dental complaints were not included. (3) Many common emergency complaints were not included. The CEDIS complaint list covered and classified 98.72% of all complaints, 55.66% more than the TTS adult complaint list.
Conclusion: The TTS adult complaint list classified less than half of complaints. We suggest that the Emergency Medicine expert panel revise the current TTS complaint list and develop a more comprehensive set of complaints in order to increase coverage and generate more reliable triage classifications.

並列關鍵字

chief complaint list ； triage ； Taiwan Triage System TTS ； Canadian Emergency Department Information System CEDIS