{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:23:15Z","timestamp":1787840595330,"version":"build-2784847793"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"\n Introduction:<\/jats:title>\n Triage is a critical process in prioritizing patients based on acuity to ensure timely care. Patients arrive at the emergency department (ED) with complaints, not diagnoses. High-risk patients are identified based on history, vital signs, mechanism of injury in trauma, and clinical findings. Chief complaints in the ED may suggest acuity independent of other clinical parameters. The objective of this study was to identify high-risk chief complaints associated with intensive care unit (ICU) admission or mortality within 72 h of ED presentation. We also characterized the chief complaints by frequency and evaluated the accuracy of the All India Institute of Medical Sciences Triage Protocol (ATP) in conjunction with high-risk complaints for predicting mortality.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This prospective observational study was conducted at AIIMS, New Delhi, from March 2021 to October 2023, including 1225 patients. Inclusion criteria covered all patients older than 16 years presenting to the ED, excluding cardiac arrest cases, pregnancy-related complications, and individuals declared dead on arrival. Data were collected using predesigned proformas. Univariate and multivariate logistic regression analyses identified high-risk chief complaints.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Of the 1754 patients screened, 1225 were included in the analysis. Thirty-four complaints were identified, with six deemed high risk. Specific complaints such as shortness of breath (odds ratio [OR] 43.691, 95% confidence interval [CI] 20.033\u201395.291,\n P<\/jats:italic>\n = 0.001), altered mental status (OR: 6.243, 95% CI: 3.282\u201311.876,\n P<\/jats:italic>\n < 0.001), hematemesis (OR: 3.88, 95% CI: 2.019\u20137.454,\n P<\/jats:italic>\n < 0.001), fall from height (OR: 3.875, 95% CI: 1.874\u20138.014,\n P<\/jats:italic>\n < 0.001), weakness of one side (OR: 3.159, 95% CI: 1.656\u20136.024,\n P<\/jats:italic>\n < 0.001), and chest pain (OR: 1.784, 95% CI: 1.22\u20133.209,\n P<\/jats:italic>\n = 0.043) were significantly associated with adverse outcomes (mortality or ICU admission) at 72 h, even after adjusting for age, gender, and comorbidities. Incorporating high-risk complaints into the ATP triage system increased predictive value (OR 3.12 vs. 7.14).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Our findings highlight specific chief complaints as valuable indicators for the early identification of patients at risk of 72-h mortality or ICU admission in the ED. Early identification of high-risk patients can enhance early resuscitation, timely referral to higher-level care, and improve patient outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jets.jets_127_24","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T08:01:18Z","timestamp":1744790478000},"page":"62-68","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Association of Presenting Complaint at Triage with 72-h Mortality and Intensive Care Admission"],"prefix":"10.4103","volume":"18","author":[{"given":"Niraj","family":"Rauniyar","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankit Kumar","family":"Sahu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharath","family":"Gopinath","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshay","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayer","family":"Jamshed","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meera","family":"Ekka","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakash Ranjan","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev","family":"Bhoi","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tej Prakash","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Rajwanshi","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, 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validation of a novel triage system developed in a middle income country \u2013 AIIMS triage protocol","volume":"15","author":"Singh","year":"2022","journal-title":"J Emerg Trauma Shock"},{"key":"R7-20260422","doi-asserted-by":"crossref","first-page":"855","DOI":"10.5811\/westjem.2022.9.56332","article-title":"Chief complaints, underlying diagnoses, and mortality in adult, non-trauma emergency department visits: A population-based, multicenter cohort study","volume":"23","author":"Arvig","year":"2022","journal-title":"West J Emerg Med"},{"key":"R8-20260422","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1111\/acem.14013","article-title":"Defining high-risk emergency chief complaints: Data-driven triage for low- and middle-income countries","volume":"27","author":"Rice","year":"2020","journal-title":"Acad Emerg Med"},{"key":"R9-20260422","doi-asserted-by":"crossref","first-page":"e000604","DOI":"10.1136\/tsaco-2020-000604","article-title":"Predicting mortality and readmission based on chief complaint in emergency department patients: A cohort study","volume":"6","author":"S\u00f8rensen","year":"2021","journal-title":"Trauma Surg Acute Care Open"},{"key":"R10-20260422","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/j.1553-2712.2007.00004.x","article-title":"Differences in long-term mortality for different emergency department presenting complaints","volume":"15","author":"Safwenberg","year":"2008","journal-title":"Acad Emerg Med"},{"key":"R11-20260422","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.ajem.2020.07.040","article-title":"Association between emergency department chief complaint and adverse hospitalization outcomes: A simple early warning system?","volume":"45","author":"Lord","year":"2021","journal-title":"Am J Emerg Med"},{"key":"R12-20260422","doi-asserted-by":"crossref","first-page":"S129","DOI":"10.1016\/j.annemergmed.2007.06.461","article-title":"412: The EMcounter project: A study of the epidemiology of medical emergencies in India","volume":"50","author":"Anthony","year":"2007","journal-title":"Ann Emerg Med"},{"key":"R13-20260422","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1136\/emj.2005.028332","article-title":"The cape triage score: A new triage system South Africa. Proposal from the cape triage group","volume":"23","author":"Gottschalk","year":"2006","journal-title":"Emerg Med J"}],"container-title":["Journal of Emergencies, Trauma, and Shock"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jets.jets_127_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:25:38Z","timestamp":1787837138000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jets.jets_127_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jets.jets_127_24","relation":{},"ISSN":["0974-2700","0974-519X"],"issn-type":[{"value":"0974-2700","type":"print"},{"value":"0974-519X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-09-15","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-02","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}