Validation of a new system for triage of ophthalmic emergencies: the Alphabetical Triage Score for Ophthalmology (ATSO)

Session Details

Session Title: Presented Poster Session: New & Interesting I

Venue: Poster Village: Pod 3

First Author: : F.D'Oria ITALY

Co Author(s): :    M. Bordinone   T. Rizzo   P. Puzo   R. Favale   S. Guerriero   G. Alessio        

Abstract Details

Purpose:

To propose a modified ophthalmic triage system based on simple ophthalmic symptoms, signs and anamnestic data and validate its safety and effectiveness.

Setting:

Ophthalmic Emergency Room (OER), Section of Ophthalmology, Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari, Bari, Italy.

Methods:

This was a prospective study conducted on all consecutive patients presenting in the OER of a single university hospital over a 2-month period. The study design analyzed a modified version of the Rome Eye Scoring System for Urgency and Emergency (RESCUE). We selected six factors as predictors of urgency levels: Altered Vision, Ocular Behavior, Color, Distress, Eye Trauma, Floaters and Flashes. Alphabetical Triage Score for Ophthalmology (ATSO) final score is obtained as the sum of scores assigned to each parameter and can be eventually converted into risk groups: low-risk group (scoring 0-3), intermediate-risk group (4-5) and high-risk group (> 6).

Results:

A total of 953 consecutive patients presented to our OER  were considered for participation in the study. The male to female ratio was 1.24:1. The mean age of the participants were 53.1 years (range 18-92, SD 18.7 years). The sensitivity of ATSO in differentiating urgent from non-urgent conditions - as assessed by the ophthalmic physician on-call after the final diagnosis have been made - based on the total score obtained by filling the triaging form 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.

Conclusions:

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. Only a few patients with an ophthalmic emergency have been missed using our score system, and few patients with non-urgent ophthalmic condition have been misdiagnosed as intermediate- or high-risk. The ATSO score may represent a valuable tool to implement triage of ocular patients in the emergency department.

Financial Disclosure:

None