Abstract
Purpose
To propose a modified ophthalmic triage system based on simple ophthalmic symptoms, signs and anamnestic data and validate its safety and effectiveness.
Methods
Phase 1 of the study was a retrospective review of chart records of patients admitted at the ophthalmic emergencies room (OER); phase 2 was a prospective study conducted on all consecutive patients presenting in the OER between April 1st, 2018, and May 30th, 2018. We selected the following six factors as predictors of urgency levels: altered vision, ocular behavior, color, distress, eye trauma, floaters and flashes. ATSO final score can be eventually converted into risk groups: low-risk group (scoring 0–3), intermediate-risk group (scoring 4–5) and high-risk group (scoring > 6).
Results
A total of 953 consecutive patients who presented to our OER over a two-month period were considered for participation in the study. The male-to-female ratio was 1.24:1. The mean age of the participants was 53 years (range 18–92, SD 19 years). ATSO score significantly correlated with urgency levels (p < .00001). The sensitivity of ATSO in differentiating urgent from non-urgent conditions was 91.4%, and the specificity was 98.2%. All hospitalized patients (30, 3.15%) have been coded as intermediate/high risk according to the ATSO score.
Conclusion
The use of the ATSO score for patients at the OER provides the clinician with a reliable predictor of urgency, being at the same time safe and effective. The ATSO score may represent a valuable tool to implement triage of ocular patients in the emergency department.
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References
Khare GD, Andrew Symons RC, Do DV (2008) Common ophthalmic emergencies. Int J Clin Pract 62(11):1776–1784
Hau S, Ioannidis A, Masaoutis P, Verma S (2008) Patterns of ophthalmological complaints presenting to a dedicated ophthalmic Accident & Emergency department: inappropriate use and patients’ perspective. Emerg Med J 25:740–744
Carvalho Rde S, José NK (2007) Ophthalmology emergency room at the University of São Paulo General Hospital: a tertiary hospital providing primary and secondary level care. Clinics (Sao Paulo) 62(3):301–308
Fenton S, Jackson E, Fenton M (2001) An audit of the ophthalmic division of the accident and emergency department of the Royal Victoria Eye and Ear Hospital, Dublin. Ir Med J 94(9):265–266
Rossi T, Boccassini B, Iossa M, Lesnoni G, Mutolo MG, Mutolo PA (2007) Triaging and coding ophthalmic emergencies: the Rome Eye Scoring System for Urgency and Emergency (RESCUE). A pilot study on 1,000 eye-dedicated emergency room patients. Eur J Ophthalmol 17(3):413–417
AlSamnan Mazen S, Mousa Ahmed, Al-Kuwaileet Safa, AlSuhaibani Adel H (2015) Triaging self-referred patients attending ophthalmic emergency room. Saudi Med J 36(6):678–684. https://doi.org/10.15537/smj.2015.6.11302
Bourges JL, Boutron I, Monnet D, Brézin AP (2015) Consensus on severity for ocular emergency: the BAsic Severity Score for Common OculaR Emergencies [BaSe SCOrE]. J Ophthalmol 2015:576983. https://doi.org/10.1155/2015/576983
Rossi T, Boccassini B, Cedrone C, Iossa M, Mutolo MG, Lesnoni G, Mutolo PA (2008) Testing the reliability of an eye-dedicated triaging system: the RESCUE. Eur J Ophthalmol 18(3):445–449
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical Board approval was obtained for the purpose of this investigation by “Comitato Etico Interregionale Azienda Ospedaliera Universitaria Policlinico di Bari”.
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D’Oria, F., Bordinone, M.A., Rizzo, T. et al. Validation of a new system for triage of ophthalmic emergencies: the alphabetical triage score for ophthalmology (ATSO). Int Ophthalmol 40, 2291–2296 (2020). https://doi.org/10.1007/s10792-020-01413-5
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DOI: https://doi.org/10.1007/s10792-020-01413-5