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Correlation between the pre-hospital triage scale and emergency department triage scale

Background: While emergency patient triage system is effective when the pre-hospital triage acuity scale is linked with the in-hospital triage acuity scale. However, the 119 emergency medical triage system and the Korea Triage and Acuity Scale are not linked in Korea. Objective: This study aimed to investigate the correlation between the two triage systems and to utilize the results as basic data for the future development of a pre-hospital triage system. Methods: Among the 1114 patients who visited a regional emergency medical center by a 119 ambulance from April to May 2016, we analyzed the correlation between the pre-hospital and in-hospital triage systems based on the general characteristics of the patients and their reason of hospital visit (non-trauma or trauma). Results: Upon reclassifying the pre-hospital and in-hospital triage systems into three levels, among the 289 patients (28.1%) in level 3 of the pre-hospital triage, 79 (27.3%) were reclassified as the highest level (Resuscitation) in the in-hospital triage. The kappa coefficient as a measure of agreement between the two triage systems was very low at 0.211 (95% confidence interval, 0.164–0.258), and the kappa coefficient of the paramedic category was 0.232 (95% confidence interval, 0.161–0.303). Conclusion: There is a low agreement between the pre-hospital and in-hospital triage systems.