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important in their clinical decision making process as they assigned an acuity level
for each individual patient. Examples of these cases are shown in Table 27.1 as well
as the calculation of the corresponding
iw
values (# of experts of considering this
fac-tor)/(total number of patient cases, i.e. 334), which will be included as factor
concepts of the CFCM-ESI, according to equation 27.3.
Table 27.1
The
importance weight iw
for Factor Concepts
#
of experts considering this factor
total number of cases
iw
=
.
Physical meaning
Patient chief complaint
0.67 = 224/334
Vital signs
0.4 = 136/334
Medical history
0.35 = 120/334
Other factor
0.32 = 110/334
Expected number of resources
0.31 = 106/334
Patient age
0.16 = 54/334
Required timely intervention
0.15 = 53/334
Additional symptoms other than chief complaint
0.14=49/334
Severe pain or distress
0.12 = 42/334
Patient referred to ED from outside
0.08 = 29/334
Behavioral or psychiatric issue
0.07 = 25/334
No additional symptoms to chief complaint
0.05=18/334
Absence of medical history
0.05 = 18/334
Patient medications
0.05 = 17/334
Hospital or ED discharge < 3 days
0.04 = 15/334
Patient immune-compromised
0.04 = 14/334
Alcohol or illicit drug use
0.03 = 13/334
However, based on bibliographic data and in order to develop an integrated ad-
vanced FCM-ESI, some additional Factor Concepts mostly related to the other 3
ESI levels but not exclusively are included:
•
Life or organ-threatening condition,
iw
45. It is concluded based on preva-
lence statistics of emergency room triaging of elderly [32] in conjunction with
the fact that this is a very significant determining factor for ESI level 1.
=
.
•
Limb threatening state
iw
40, based on prevalence statistics of limb loss in
the general population [29] and elderly visits to the ED in conjunction with the
fact that this is a very significant determining factor for ESI level 1.
=
0
.
•
Weakness,
iw
=
0
.
20 [28]
•
No recent change mental state,
iw
=
0
.
75 [51]
•
Patient can walk or sit for prolonged periods
iw
=
0
.
12, based on non-urgent
presentations [2]
