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Published on: June 10, 2025

Prediction of emergent heart failure death by semi-quantitative triage risk stratification

Harriette G C Van Spall1, Clare Atzema, Michael J Schull

  • 1Population Health Research Institute, Hamilton Health Science and McMaster University, Hamilton, Canada.

Plos One
|August 20, 2011
PubMed

Insights

The Canadian Triage Acuity Scale (CTAS) effectively predicts early death in emergency department heart failure patients. Higher CTAS scores indicate increased mortality risk, especially when considering comorbidities.

Area of Science:

  • Emergency Medicine
  • Cardiology
  • Health Services Research

Background:

  • Generic triage tools are used in emergency departments but lack validation for acute heart failure (HF) patients.
  • Predicting short-term mortality risk in HF patients is crucial for timely intervention.

Purpose of the Study:

  • To evaluate the Canadian Triage Acuity Scale (CTAS) for predicting early death in emergency department (ED) patients with acute heart failure (HF).

Main Methods:

  • Retrospective analysis of 68,380 HF patients presenting to an Ontario ED between April 2003 and March 2007.
  • Utilized National Ambulatory Care Reporting System and vital statistics databases to track outcomes.
  • Assessed CTAS scores, vital signs (oxygen saturation, respiratory rate), mode of arrival, and comorbidities.

Main Results:

  • Early mortality rates at 1-day and 7-days increased significantly with higher CTAS scores (CTAS 1 showing highest risk).
  • CTAS 1, low oxygen saturation, rapid respiratory rate, and paramedic arrival predicted triage-critical status.
  • CTAS demonstrated good discrimination for ED and 1-day death, with improved prediction when incorporating comorbidities.

Conclusions:

  • The CTAS, primarily based on respiratory factors, effectively predicts emergent death in acute heart failure patients presenting to the ED.
  • Incorporating comorbidities further enhances the predictive accuracy of the CTAS for mortality risk in this population.
Abstract

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