The impact of WHO triage on mortality rate in an emergency department in Erbil, Kurdistan region of Iraq

Background and objective: Triage is a process that includes categorizing patients according to the severity of their illnesses or injuries. This practice offers the potential to enhance the quality of healthcare and reduce the mortality rate. The Integrated Interagency Triage Tool (IITT) is a recently implemented triage system developed by the World Health Organization (WHO). The study aimed to examine the impacts of implementing the triage methods on the death rates of patients visiting the Rizgary Emergency Department. Methods: This observational study includes the examination and comparing the mortality rate of any patient admitted to Rizgary emergency department in Erbil between January-June 2022, which was before implementing the triage system, and also during that period in 2023 in which the triage system was implemented. For each month, collected data included the number of deaths, admissions, and reasons for death. Cases related to cancer and major trauma were excluded from the study. Results: Six months after the triage system was implemented, 26,015 patients were admitted, slightly more than the previous year (25,715 patients). The total number of deaths decreased by 41.7% after implementing the triage system. The mean mortality rate decreased from 6.80 deaths per 1,000 in 2022 to 3.94 deaths per 1,000 in 2023, which was statistically significant (P = 0.010). Conclusion: Implementing the WHO triage system significantly reduced patient mortality in the emergency department by 41.7%, resulting from correct classification and optimal use of available time and resources.