Assessing the validity of the Triage Risk Screening Tool in a third world setting

Background: Social risk is rarely evaluated in older emergency department (ED) patients, although its identification can reduce re-attendance. Objectives: This study assessed the diagnostic accuracy of the Triage Risk Screening Tool (TRST) in the ED of a developing country.

Methods: The diagnostic accuracy of TRST to detect elders at risk was compared to routine clinical evaluation, using a comprehensive evaluation by an experienced social worker as the ‘gold standard’. The inter-rater reliability of the TRST was assessed on a separate cohort of patients prior to the main study.

Results: The sensitivity of the TRST was 94.7% vs 55.6% for physician assessment (p = 0.025). The TRST had good inter-rater reliability (Cohen’ Kappa = .882), and physicians found it easy to use. Conclusion: The TRST provides a rapid means of assessing risk in older ED attenders. This study confirmed the validity of this screening tool in a third world setting.