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Validation of the Cipto Triage Method: A Single-Centre Study from Indonesia
Hadiki Habib1, Septo Sulistio1, Imamul Aziz Albar1
1Emergency Unit, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Open Access Emergency Medicine : OAEM
|June 18, 2020
Summary
The Cipto Triage Method (CTM) demonstrates over 80% accuracy in Indonesian emergency departments. This validated method effectively identifies critical patients, reducing mortality risk associated with undertriage.
Area of Science:
- Emergency Medicine
- Health Services Research
- Clinical Triage
Background:
- Developing countries face challenges in emergency care due to resource limitations.
- Effective triage systems are crucial for prioritizing patients in busy emergency departments.
- The Cipto Triage Method (CTM) was developed to address these needs in Indonesia.
Purpose of the Study:
- To validate the performance of the Cipto Triage Method (CTM).
- To assess the accuracy and effectiveness of a three-category triage system in a developing country's emergency department.
Main Methods:
- A retrospective, single-centre cohort study was conducted at Cipto Mangunkusumo Hospital's emergency department.
- 1348 patient records from 2017 were randomly selected for analysis.
- Validation used expert opinion and patient outcomes (admission, mortality) as reference standards.
Main Results:
- The Cipto Triage Method (CTM) achieved overall accuracy exceeding 80%.
- The resuscitation category showed high positive (99%) and negative (96.9%) predictive values.
- Patients triaged as resuscitation had significantly higher risks of admission (RR 1.341) and mortality (RR 4.294). Undertriage increased mortality risk (RR 3.1).
Conclusions:
- The Cipto Triage Method (CTM) demonstrates good criterion and construct validity.
- CTM is user-friendly and adaptable to the typical emergency department designs found in Indonesian hospitals.
- The study supports CTM's utility as an effective triage tool in resource-limited settings.