Clinical Validity of Using the Pediatric Assessment Triangle in a Pediatric Emergency Department

Siqi Zhu^1,2*Yufen Wu¹Biyan Yu¹Biyu Shen³Linjie Fang¹Biru Li^1,3*Long Xiang^1,3*

• ¹Department of Emergency Medicine, Shanghai Children's Medical Center, Shanghai, China
• ²Department of Neurology, Shanghai Children's Medical Center, Shanghai, China
• ³Other, Shanghai, China

Objectives: To evaluate the clinical validity of the Pediatric Assessment Triangle (PAT) in a pediatric emergency department (PED).We conducted a retrospective analysis of 799 children who visited our PED and collected data on age, sex, disease severity, expense, and disposition. We analyzed the correlations between PAT and disease, age, waiting time, disposition, and cost.Results: 429 males (53.7%) and 370 females (46.3%), with an average age of 4.97 years. The numbers of children in levels 2, 3, and 4 were five (0.6%), 158 (19.8%), and 636 (79.6%), respectively. Respiratory system diseases comprised 78.7% of all disease cases. The top three highest proportions of critical cases were endocrine system diseases (100%), toxic exposure (50%), and circulatory system diseases (40%). Children aged 3-8 years account for 45.3% of the cases. The incidence of critical cases was most prevalent within the neonatal population (21.4%), followed by children aged 8-15-years (2.1%) and 3-8-years (0.6%), respectively. The area under the receiver operating characteristic curve for the PAT in predicting hospitalization was 0.966. The mean waiting time for level-2 children was 3.80 min.As a tool used for PED triage, PAT can specifically identify critical cases, particularly in recognition of pediatric respiratory emergencies and neonatal emergencies; and demonstrates significant superiority. Future multicenter studies should be conducted in pediatric emergency medical centers further to investigate the effectiveness of PAT in PED triage.