Background
Methods
Development of WEST
Design, study population, and education of test nurses
Data collection and statistical analysis
Results
Study population
All EDs | ED1 | ED2 | ED3 | AMB | |
---|---|---|---|---|---|
Total number (N) | 1510 | 551 | 569 | 318 | 72 |
Age, years (median) (range) | 52(12a–100) | 54(12a–100) | 47(33–95) | 51(21–93) | 67(19–97) |
Sex (w/m) (n/n) | 762/748 | 289/262 | 282/287 | 158/160 | 33/39 |
Chief complaint (n) | |||||
Abdominal pain | 263 | 115 | 143 | 1 | 4 |
Chest pain | 136 | 60 | 65 | 5 | 6 |
Infection | 124 | 47 | 55 | 16 | 6 |
Otherb | 118 | 50 | 50 | 12 | 6 |
Hand trauma | 89 | 2 | 5 | 82 | 0 |
Dyspnea | 72 | 28 | 25 | 9 | 10 |
Other trauma | 69 | 10 | 15 | 39 | 5 |
Musculoskeletal/extremity pain | 66 | 22 | 25 | 19 | 0 |
Unspecified disease | 65 | 35 | 22 | 3 | 5 |
Foot trauma | 61 | 1 | 5 | 54 | 1 |
Arrhythmia/palpitations | 52 | 24 | 21 | 2 | 5 |
Urological symptoms | 48 | 34 | 11 | 2 | 1 |
Head trauma | 41 | 20 | 13 | 3 | 5 |
Arm trauma | 40 | 2 | 0 | 38 | 0 |
Headache | 39 | 15 | 21 | 3 | 0 |
Vertigo/dizziness | 38 | 19 | 13 | 1 | 5 |
Neurological deficits | 38 | 18 | 14 | 5 | 1 |
Back pain | 31 | 6 | 11 | 14 | 0 |
Rectal symptoms | 20 | 4 | 16 | 0 | 0 |
Ear nose or throat problem | 16 | 10 | 6 | 0 | 0 |
Wound (cut or laceration) | 15 | 10 | 5 | 0 | 0 |
Allergy | 15 | 3 | 10 | 2 | 0 |
Eye symptoms | 10 | 0 | 10 | 0 | 0 |
Seizure | 9 | 3 | 1 | 0 | 5 |
GI-bleed | 9 | 4 | 2 | 0 | 3 |
Fainting/syncope | 9 | 4 | 3 | 1 | 1 |
Post-operational | 9 | 2 | 0 | 7 | 0 |
Intoxication | 8 | 3 | 2 | 0 | 3 |
Evaluation of RETTS© and WEST triage levels
Red to yellow | Orange to green | Orange to blue | Yellow to blue | |
---|---|---|---|---|
Cause | ||||
Single high vital parameter | 3 | 8 | 1 | 0 |
Anticoagulation use and mild trauma or GI/URO-bleed | 0 | 4 | 0 | 0 |
Neurological deficit | 0 | 4 | 0 | 0 |
Laboratory | 0 | 2 | 0 | 0 |
Othera | 2 | 6 | 0 | 6 |
Evaluation of discharge categories and events within 72 h
RETTS© | WESTa | Discharge category | ||||
---|---|---|---|---|---|---|
Home | Referralb | Ward | ICU | LWBSc | ||
Red, 42 | Red, 25 | 1(4%) | 2(8%) | 21(84%) | 1(4%) | 0 |
Orange, 10 | 1(10%) | 1(10%) | 8(80%) | 0 | 0 | |
Yellow, 5 | 2(40%) | 0 | 3(60%) | 0 | 0 | |
Green, 1 | 1(100%) | 0 | 0 | 0 | 0 | |
Blue, 0 | 0 | 0 | 0 | 0 | 0 | |
Orange, 192 | Red, 0 | 0 | 0 | 0 | 0 | 0 |
Orange, 95 | 47(49%) | 3(3.1%) | 43(45%) | 1(1%) | 1(1%) | |
Yellow, 68 | 43(63%) | 1(1.5%) | 23(34%) | 0 | 1(1.5%) | |
Green, 26 | 16(61.5%) | 2(7.7%) | 8(31%) | 0 | 0 | |
Blue, 1 | 0 | 1(100%) | 0 | 0 | 0 | |
Yellow, 657 | Red, 1 | 1(100%) | 0 | 0 | 0 | 0 |
Orange, 13 | 6(46%) | 0 | 7(54%) | 0 | 0 | |
Yellow, 258 | 181(70%) | 26(10%) | 39(15%) | 0 | 12(4.6%) | |
Green, 376 | 265(70%) | 54(14%) | 37(10%) | 0 | 20(5%) | |
Blue, 6 | 5(83%) | 0 | 0 | 0 | 1(17%) | |
Green, 546 | Red, 0 | 0 | 0 | 0 | 0 | 0 |
Orange, 7 | 3(43%) | 0 | 4(57%) | 0 | 0 | |
Yellow, 22 | 17(77%) | 1(4.5%) | 4(18%) | 0 | 0 | |
Green, 491 | 283(58%) | 173(35%) | 15(3%) | 0 | 20(4%) | |
Blue, 26 | 17(65%) | 6(23%) | 1(4%) | 0 | 2(8%) | |
Blue, 71 | Red, 0 | 0 | 0 | 0 | 0 | 0 |
Orange, 0 | 0 | 0 | 0 | 0 | 0 | |
Yellow, 0 | 0 | 0 | 0 | 0 | 0 | |
Green, 1 | 0 | 1(100%) | 0 | 0 | 0 | |
Blue, 70 | 34(48.6%) | 33(47%) | 2(3%) | 0 | 1(1.4%) |
RETTS© | WEST* | Events within 72 h | |||
---|---|---|---|---|---|
Planned revisit | Unplanned revisits | Death | ICU | ||
Red, 42 | Red, 25 | 0 | 0 | 2 (8%) | 0 |
Orange, 10 | 0 | 0 | 1(10%) | 0 | |
Yellow, 5 | 0 | 0 | 0 | 0 | |
Green, 1 | 0 | 0 | 0 | 0 | |
Blue, 0 | 0 | 0 | 0 | 0 | |
Orange, 192 | Red, 0 | 0 | 0 | 0 | 0 |
Orange, 95 | 1(1%) | 6(6.3%) | 0 | 1(1%) | |
Yellow, 68 | 1(1.5%) | 5(7.3%) | 0 | 0 | |
Green, 26 | 1(3.8%) | 2(7.7%) | 0 | 0 | |
Blue, 1 | 0 | 0 | 0 | 0 | |
Yellow, 657 | Red, 1 | 0 | 0 | 0 | 0 |
Orange, 13 | 0 | 0 | 0 | 0 | |
Yellow, 258 | 7(2.7%) | 13(5%) | 0 | 0 | |
Green, 376 | 8(2.1%) | 18(4.8%) | 0 | 0 | |
Blue, 6 | 0 | 1(16.6%) | 0 | 0 | |
Green, 546 | Red, 0 | 0 | 0 | 0 | 0 |
Orange, 7 | 0 | 0 | 0 | 0 | |
Yellow, 22 | 0 | 3(13.6%) | 0 | 0 | |
Green, 491 | 8(1.6%) | 29(6%) | 0 | 0 | |
Blue, 26 | 0 | 1(3.8%) | 0 | 0 | |
Blue, 71 | Red, 0 | 0 | 0 | 0 | 0 |
Orange, 0 | 0 | 0 | 0 | 0 | |
Yellow, 0 | 0 | 0 | 0 | 0 | |
Green, 1 | 0 | 0 | 0 | 0 | |
Blue, 70 | 1(1.4%) | 5(7%) | 0 | 0 |