ปัจจัยที่มีความสัมพันธ์กับการคัดกรองผู้ป่วยฉุกเฉินในโรงพยาบาลโพนทอง

Maritsada  Sudsang

Authors

Maritsada Sudsang Phonthong Hospital

Keywords:

Emergency Severity Index, Triage, Over triage

Abstract

Purposes : To identify factors associated with discordance between the actual care provided and Emergency Severity Index (ESI) level 2, in order to develop a local triage protocol.

Study design : A prospective observational study.

Materials and Methods : The study included patients in the Emergency Department of Phonthong Hospital between April 1 and April 30, 2026. Patients were classified into two groups: Concordant group, in which care provided was consistent with ESI-2, and Discordant group, in which care provided was inconsistent with ESI-2. Compared patient characteristics between groups to identify factors associated with Discordant ESI.

Main findings : Among 338 patients, 19.2% were classified as Discordant ESI. Factors significantly associated with Discordant ESI included having no underlying disease (adjusted OR 2.268, 95% CI 1.116–4.605, p=.024), hypertension without target organ damage (adjusted OR 8.801, 95% CI 3.634–21.314, p<.001), heart rate in dangerous zone (Adjusted OR 5.502, 95%CI 2.628–11.518, p<.001), and scheduled follow up without abnormal symptoms (adjusted OR 4.368, 95%CI 1.220–15.634, p=.023). Patients aged 18–65 years (Adjusted OR 0.176, 95%CI 0.074–0.420, p<.001) and those aged over 65 years (Adjusted OR 0.144, 95%CI 0.048–0.431, p=.001) had lower odds of Discordant ESI compared with the reference group.

Conclusion and recommendations : Factors associated with Discordant ESI included having no underlying disease, hypertension without target organ damage, heart rate in dangerous zone, and scheduled follow-up without abnormal symptoms. Age was also associated with Discordant ESI, with patients aged 18–65 years and those over 65 years having lower odds compared with the reference group. These patient characteristics can be used to develop a local triage protocol to reducing ED overcrowding and improving the efficiency of resource utilization.

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