DÄ internationalArchive16/2011No System Should Be Preferred
LNSLNS

The topic of triage systems is becoming increasingly important in the setting of emerging interdisciplinary emergency departments in Germany. The authors thus deserve thanks for their review article.

However, readers of the article might reach the conclusion that the German version of Emergency Severity Index (ESI) triage is recommended as triage instrument for German-speaking emergency departments. This is explained with a study that was published online in 2010 (1). But the current review article was written on the basis of a selective literature search in early 2009. At least 2 more important studies on triage systems in emergency admission were published in 2009 (online publication in 2008), in addition to the one mentioned above:

  • A Portuguese study on the Manchester Triage System MTS with >300,000 patients showed significant results regarding category of triage and survival and hospital admission respectively (2).
  • A study comparing the reliability of the MTS and the ESI showed higher kappa values for the MTS (0.76 vs 0.46) (3).

In my opinion, no unequivocal recommendation for preferring either of the two systems is therefore possible on the basis of the current literature.

DOI: 10.3238/arztebl.2011.0282

Dr. med. Christoph Wasser

Auerbachstr. 110

70376 Stuttgart, Germany

christoph.wasser@rbk.de

Conflict of interest statement

The author declares that no conflict of interest exists.

1.
Grossmann FF, Nickel CH, Christ M, Schneider K, Spirig R, Bingisser R: Transporting clinical tools to new settings: cultural adaptation and validation of the Emergency Severity Index in German. Ann Emerg Med 2010; epub, ahead of print. MEDLINE
2.
Martins HM, Cuna LM, Freitas P: Is Manchester (MTS) more than a triage system? A study of its association with mortality and admission to a large Portuguese hospital. Emerg Med J 2009; 26: 183–6. MEDLINE
3.
Storm-Versloot MN, Ubbink DT, Chin a Choi V, Luitse JS: Observer agreement of the Manchester Triage System and the Emergency Severity Index: a simulation study. Emerg Med J 2009; 26: 556–60. MEDLINE
4.
Christ M, Grossmann F, Winter D, Bingisser R, Platz E: Modern
triage in the emergency department. Dtsch Arztebl Int 2010; 107(50): 892–8.
VOLLTEXT
1.Grossmann FF, Nickel CH, Christ M, Schneider K, Spirig R, Bingisser R: Transporting clinical tools to new settings: cultural adaptation and validation of the Emergency Severity Index in German. Ann Emerg Med 2010; epub, ahead of print. MEDLINE
2.Martins HM, Cuna LM, Freitas P: Is Manchester (MTS) more than a triage system? A study of its association with mortality and admission to a large Portuguese hospital. Emerg Med J 2009; 26: 183–6. MEDLINE
3.Storm-Versloot MN, Ubbink DT, Chin a Choi V, Luitse JS: Observer agreement of the Manchester Triage System and the Emergency Severity Index: a simulation study. Emerg Med J 2009; 26: 556–60. MEDLINE
4.Christ M, Grossmann F, Winter D, Bingisser R, Platz E: Modern
triage in the emergency department. Dtsch Arztebl Int 2010; 107(50): 892–8.
VOLLTEXT