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2006, Number 1

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Med Crit 2006; 20 (1)

Clinical agreement in the evaluation of illness severity of patients in emergency room

Rodríguez-Pimentel L, Garduño-Espinoza J, Estrada PN, Silva RR

Language: Spanish
References: 36
Page: 16-24
PDF size: 113.69 Kb.


ABSTRACT

Objective: To determine the efficacy of physicians to evaluate the degree of illness severity of patients admitted to an emergency room.
Design: Transversal and comparative study.
Setting: Emergency Room of a tertiary care hospital, Mexico City.
Method: Two internist physicians qualified independently and blindly the severity of illness of twenty patients admitted to an emergency room. Six scales were used: three subjective scales (Clinical Evaluation Scale which qualified the patients as mild, seriously and very seriously ill; Physical Status Classification of the Anaesthesiologist American Society [ASA]; and Visual Analogue Scale; and three objective scales (Simplified Acute Physiology Score [SAPS II]; Therapeutic Intervention Scoring System [TISS] and Charlson Comorbidity Index).
Results: Clinical Classification Scale had an agreement of Kappa coefficient = 0.22 and ASA classification = 0.25 (p ‹ 0.02), the agreement of Visual Analogue Scale determined through Ri was 0.59, TISS 0.60 (IC 95% [0.01 to 0.84]), Charlson Comorbidity 0.86 (IC 95% [0.71 to 0.95]) and SAPS II Score 0.96 (IC 95% [0.84 to 0.98]).
Conclusion: The use of objective scales of illness severity is more appropriate to evaluate the patients admitted to an emergency room.


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