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A decade of triage with the Manchester Triage System-The MTS big data study
Ingo Gräff1, Moritz Berger2,3, Matthias Schmid2
1Department of Clinical Acute and Emergency Medicine, University Hospital Bonn, Bonn, Germany.
Plos One
|April 8, 2026
Summary
The Manchester Triage System (MTS) accurately and stably prioritizes emergency patients over a decade, demonstrating its reliability despite various external challenges.
Area of Science:
- Emergency Medicine
- Healthcare Systems Analysis
- Patient Triage
Background:
- Limited longitudinal data on triage system performance.
- Assessing the Manchester Triage System (MTS) over 10 years.
- Evaluating MTS stability amidst external factors like staff turnover and policy changes.
Purpose of the Study:
- Determine the accuracy of initial patient assessments using the MTS.
- Assess the stability of the MTS over a decade.
- Investigate MTS performance under external influences.
Main Methods:
- Large-scale, monocentric, retrospective observational study.
- Inclusion of 355,135 emergency patients (2014-2023).
- Analysis of patient demographics, triage urgency levels, and survival outcomes.
Main Results:
- MTS urgency level distribution remained stable.
- Consistent prediction accuracy for hospital and ICU admission (AUCs 0.719-0.862).
- High 12-hour survival (>0.99 for blue-orange, >0.89 for red); 30-day survival stable for blue-orange, declining for red.
Conclusions:
- MTS demonstrates construct validity, reliably assigning urgency levels.
- MTS accuracy remained stable over ten years despite significant external changes.
- MTS is robust and reliable for emergency patient prioritization in high-volume settings.
