Evaluation of the Australian Triage Scale in patients who present to the emergency department with upper gastrointestinal bleeding

Evaluation of the Australian Triage Scale in patients who present to the emergency department with upper gastrointestinal bleeding BACKGROUND: Upper gastrointestinal bleeding (UGIB) is a common presentation to the emergency department (ED). Study aims were to evaluate the utility of the Australasian Triage Score (ATS) in patients presenting to the ED with UGIB.

Methods: This retrospective observational study included 356 patients over a 2-year period who presented to a metropolitan hospital ED. The ATS was categorised into three groups, ATS 1/2, ATS 3 and ATS 4/5. Primary outcomes explored the relationship between ATS and haemodynamic parameters. Secondary outcomes evaluated the proportion of patients with suspected variceal bleeding and allocated a non-life-threatening ATS category.

Results: The study population were distributed by ATS 1/2 (28.7 %), ATS 3 (46.6 %) and ATS 4/5 (24.7 %). Over half of patients with some haemodynamic compromise were allocated an ATS 3 or 4/5. Additionally, 56 % with suspected variceal bleeding and 51 % with syncope were also allocated an ATS category (3 or 4/5).

Conclusions: The utility of the ATS recognises most patients presenting with UGIB at high-risk of adverse outcomes. Additional screening at triage maybe beneficial for those patients with a history of cirrhosis or varices, and UGIB-related syncope. Consideration of an ATS category of 2 for these patients may enable them to access earlier time-critical therapies.