The effect of Heart Failure Triage Scale on used resources among heart failure patients with Dyspnea in the emergency department: a randomized clinical trial

It is unclear whether triage scales are able to identify high risk patients with heart failure (HF) or not. The aims of study were to compare the effect of heart failure triage scale (HFTS) and emergency severity index (ESI) on mistriage among patients with heart failure who present to the emergency department (ED). A randomized clinical trial was conducted from April to June 2017. 153 HF patients with dyspnea were randomly assigned to HFTS or ESI groups. Triage level and used resources were compared between both groups among HF patients who admitted to coronary care unit (CCU), cardiac unit (CU) and discharged patients from the ED. Content validity was examined using Kappa designating agreement on relevance (k*). Reliability of both scale was evaluated using interobserver agreement (Kappa). Mean age was 62.53 years old. Seventy five and 78 HF patients were assigned to HFTS and ESI groups respectively. Triage level between HFTS and ESI groups was significantly different among patients admitted to CCU (1.0 vs. 2.8), cardiac unit (2.26 vs. 3.06) and discharged patients from the ED (3.53 vs. 2.86). Used resources in HFTS group was significantly different among triage levels (H = 25.89; df = 3; p < 0.001(. HFTS was valid and reliable. HFTS provides a more accurate method for triaging HF patients compared to ESI. It is recommended to make use of HFTS to triage HF patients in the ED.