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The predictive validity of RETTS-HEV as an acuity triage tool in the emergency department of a Danish Regional Hospital

Pérez, Noela; Nissen, Louisea; Nielsen, Rasmus F.a; Petersen, Poula; Biering, Karinb

European Journal of Emergency Medicine: February 2016 - Volume 23 - Issue 1 - p 33–37
doi: 10.1097/MEJ.0000000000000173

Introduction The Rapid Emergency Triage and Treatment System – Hospital Unit West (RETTS-HEV) is a triage system used in the emergency department (ED) in Herning, Denmark, since 2010. It categorizes patients according to priority and defines a time limit on how long patients can wait before being seen by a doctor depending on the severity of their condition. The purpose of this study was to determine the predictive validity of RETTS-HEV by measuring the association between triage scores and outcomes such as the admission rate, the length of stay (LOS), and mortality.

Materials and methods We performed an observational cohort study by examining the medical records of all patients who attended the ED from 1 September 2012 to 30 November 2012, at the Regional Hospital West Jutland in Herning, Denmark (N=4680). We defined the following outcomes to make associations with the patients’ triage category: in-hospital mortality, and 30, 60, and 90-day mortalities, the hospital LOS and the admission rate, on the basis of complete information from the Danish National Patient Registry.

Results The distribution of age, comorbidity, admission, LOS, and mortality over triage categories differed as expected. After making adjustments for these differences, we found a consistent association between triage categories and in-hospital mortality, and 30, 60, and 90-day mortalities, the hospital LOS, and the admission rate.

Conclusion RETTS-HEV was found to be closely related to all examined outcomes, and therefore useful in the risk stratification of ED patients.

Departments of aEmergency

bOccupational Medicine, Regional Hospital of Herning, Herning, Denmark

Correspondence to Noel Pérez, MD, Department of Emergency, Regional Hospital of Herning, Gl. Landevej 61, Herning 7400, Denmark Tel: +45 5193 0152; fax: +45 7843 2061; e-mail:

Received December 12, 2013

Accepted April 25, 2014

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