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Validity of the Korean Triage and Acuity Scale for predicting 30-day mortality due to severe trauma: a retrospective single-center study



Since January 2016, emergency medical centers in South Korea have used the Korean Triage and Acuity Scale (KTAS) as the initial triage tool for all patients, including trauma patients, who visited the emergency department (ED). This present study aimed to assess the validity of the KTAS for predicting 30-day mortality due to severe trauma.


This retrospective study included patients with severe trauma (injury severity score ≥ 16) from January 2016 to December 2017. Using KTAS, all patients were triaged as levels 1, 2, 3, and 4 by triage nurses. The primary outcome was 30-day mortality, and the secondary outcome was disposition at the ED. Disposition at the ED included admission to the general ward, intensive care unit, or operation room or death in the ED.


Of the 827 included patients, 30-day mortality was observed in 14.9% (n = 123) of patients. Mortality was observed in 52.5% (n = 42), 15.5% (n = 69), 4.1% (n = 12), and 0.0% (n = 0) of patients in levels 1, 2, 3, and 4, respectively. The Cox proportional hazard regression analysis showed that compared to level 3, level 1 [hazard ratio (HR) 4.868; 95% confidence interval (CI) 2.341–10.119] and level 2 (HR 2.070; 95% CI 1.083–3.956) were independently associated with 30-day mortality. Patients with lower KTAS levels were more likely to be admitted to the operation room and were more likely to die in the ED.


Lower KTAS levels were associated with higher 30-day mortality due to severe trauma. KTAS shows adequate validity for predicting 30-day mortality from severe trauma.

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We thank Mr. Seong Woo Yun for his generous support. He helped us to gather data when we drafted the first manuscript and advised us to revise the manuscript.


This study was supported by a Grant (CRI 18007-1) from Chonnam National University Hospital Biomedical Research Institute.

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Correspondence to Dong Hun Lee.

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Conflict of interest

All authors (Yong Deok Lim, Dong Hun Lee, Byung Kook Lee, Yong Soo Cho, Goeun Choi, and Seong Woo Yun) report no conflicts of interest relevant to this article. No funds were received by any of the authors in support of this study.

Ethical approval

The present study protocol was reviewed and approved by the institutional review board of Chonnam National University College of Medicine (Reg. no. CNUH-2018-066).

Informed consent

Informed consent was waived due to the retrospective nature of the study by the institutional review board.

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Lim, Y.D., Lee, D.H., Lee, B.K. et al. Validity of the Korean Triage and Acuity Scale for predicting 30-day mortality due to severe trauma: a retrospective single-center study. Eur J Trauma Emerg Surg 46, 895–901 (2020).

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  • Trauma
  • Triage
  • Mortality
  • Korean Triage and Acuity Scale