External validation of the TFC (triage frailty and comorbidity) tool: a prospective observational study.

IF 3.2 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Internal and Emergency Medicine Pub Date : 2024-09-06 DOI:10.1007/s11739-024-03757-7

Arian Zaboli, Serena Sibilio, Gloria Brigiari, Magdalena Massar, Marta Parodi, Gabriele Magnarelli, Francesco Brigo, Gianni Turcato

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引用次数: 0

Abstract

Assessing patient frailty during triage evaluations has become increasingly relevant in Emergency Departments (ED). This study aimed to externally validating the Triage Frailty and Comorbidity (TFC) tool. This prospective study was conducted from June 1 to December 31, 2023. During this period, 12 triage nurses applied the TFC tool during triage evaluation of ED patients. We used receiver operating characteristic (ROC) curves and Decision Curve Analysis to assess the predictive ability of the TFC tool for a 90-day mortality (the same endpoint used during tool development) and a 30-day mortality. 1270 patients were included and 56 of them died within 90 days. The TFC tool had an AUROC of 0.894 (0.858-0.929) for 90-day mortality and 0.885 (0.834-0.938) for 30-day mortality. In Decision Curve Analysis, it yielded higher net benefits up to a threshold probability of 0.30. The externally validated TFC tool appears very effective at identifying patients with increased risk of 90-day mortality after ED attendance. It could be implemented in clinical practice and enhance the predictive ability of standard triage systems.

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TFC（虚弱与合并症分诊）工具的外部验证：一项前瞻性观察研究。

在急诊科（ED）的分诊评估过程中评估患者的虚弱程度已变得越来越重要。本研究旨在从外部验证分诊虚弱和合并症（TFC）工具。这项前瞻性研究于 2023 年 6 月 1 日至 12 月 31 日进行。在此期间，12 名分诊护士在对急诊室患者进行分诊评估时使用了 TFC 工具。我们使用接收器操作特征曲线 (ROC) 和决策曲线分析法来评估 TFC 工具对 90 天死亡率（与工具开发期间使用的终点相同）和 30 天死亡率的预测能力。共纳入了 1270 名患者，其中 56 人在 90 天内死亡。TFC 工具对 90 天死亡率的 AUROC 为 0.894（0.858-0.929），对 30 天死亡率的 AUROC 为 0.885（0.834-0.938）。在决策曲线分析中，在阈值概率为 0.30 的情况下，该工具产生的净效益更高。经外部验证的 TFC 工具在识别急诊室就诊后 90 天死亡风险增加的患者方面似乎非常有效。它可以在临床实践中应用，并提高标准分诊系统的预测能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Internal and Emergency Medicine 医学-医学：内科

CiteScore

7.20

自引率

4.30%

发文量

258

审稿时长

6-12 weeks

期刊介绍： Internal and Emergency Medicine (IEM) is an independent, international, English-language, peer-reviewed journal designed for internists and emergency physicians. IEM publishes a variety of manuscript types including Original investigations, Review articles, Letters to the Editor, Editorials and Commentaries. Occasionally IEM accepts unsolicited Reviews, Commentaries or Editorials. The journal is divided into three sections, i.e., Internal Medicine, Emergency Medicine and Clinical Evidence and Health Technology Assessment, with three separate editorial boards. In the Internal Medicine section, invited Case records and Physical examinations, devoted to underlining the role of a clinical approach in selected clinical cases, are also published. The Emergency Medicine section will include a Morbidity and Mortality Report and an Airway Forum concerning the management of difficult airway problems. As far as Critical Care is becoming an integral part of Emergency Medicine, a new sub-section will report the literature that concerns the interface not only for the care of the critical patient in the Emergency Department, but also in the Intensive Care Unit. Finally, in the Clinical Evidence and Health Technology Assessment section brief discussions of topics of evidence-based medicine (Cochrane’s corner) and Research updates are published. IEM encourages letters of rebuttal and criticism of published articles. Topics of interest include all subjects that relate to the science and practice of Internal and Emergency Medicine.