Evaluation of a new triage scale on patients’ classification in a teaching emergency department: a retrospective study

CHAUVIN A, TRUCHOT J, OULED N, DURAND STOCCO C, PLAISANCE P, SEGAL N. Evaluation of a new triage scale on patients’ classification in a teaching emergency department: A retrospective study. Med Emergency, MJEM 2016; 24:5-10.

Key words: emergency, emergency severity index version 4, triage scale

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  • Article history / info
  • Conflict of interest statement

Correspondent author: Anthony CHAUVIN, MD

Service d’Accueil des Urgences, Hospital Lariboisière, Paris, France

2, rue Ambroise Pare, 75010 Paris France


Chauvin A, MD, Truchot J, MD, Ouled N, MD, Durand Stocco C, MD, Plaisance P, MD, Segal N, MD

University Paris Diderot, Sorbonne Paris Cité, AP-HP, Hôpital Lariboisière, Services des Urgences, F-75018 Paris, France

Category: Original article

Received: July 29, 2015

Revised: Aug. 19, 2015

Accepted: Sept. 2, 2015

There is no conflict of interest to declare



Background: Triage is a sorting of patients specific to the emergency department. Its objective is to optimize patient waiting time according to patient pathology or condition severity. The main scale used in France for triage is the French Emergency Nurses Classification (Classification Infirmière des Malades aux Urgences, CIMU). Currently, in our emergency department, triage nurses use the CIMU. As part of departmental reorganization, the triage scale was to be changed from the CIMU to the Emergency Severity Index (ESI). The main objective of this study was to evaluate whether the use of the new triage scale significantly modified patient care track orientation.

Methods: This was a single center, retrospective, observational study using medical file data collected over seven consecutive days chosen randomly. All patients in the emergency department during this period were included. Patient care track decisions were based on actual CIMU and proposed ESI version 4 results were noted for each patient: intensive care (IC), long track (L), and fast track (F). Patient care track decisions and scale results were compared using Pearson Chi2 tests.

Results: 1,181 patients were included. Results for the CIMU and the ESI respectively were: IC 94 (8%), L 485 (41%), F 583 (49%), and others 19 (2%), versus IC 86 (7%), L 242 (21%), and F 853 (72%). Patient care track decisions differed between the two scales (p < 0.001).

Conclusion: This study demonstrates that the use of ESI significantly changes patient care track decisions and therefore also patient care area assignments. The use of the ESI V4 scale will result in a more even distribution of patients between medical areas.

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