A Brief Tool to Predict Agitation in Pediatric Emergency Psychiatric Patients.
Nurse triage score predicted which pediatric emergency department psychiatric patients needed agitation treatment.
A Brief Tool to Predict Agitation in Pediatric Emergency Psychiatric Patients.
To validate the 5-item Brief Rating of Aggression in Children and Adolescents-Short (Brief Rating of Aggression in Children and Adolescents-Short) completed by emergency department (emergency department) nurses at triage for predicting agitation requiring intervention (agitation requiring intervention) among pediatric emergency department psychiatric or mental and behavioral health (mental and behavioral health) encounters.
We conducted a prospective observational prognostic validation study (October 2024-November 2025) at 2 pediatric EDs.
moderate accuracy at distinguishing who will need agitation treatment, 1.0 is perfect
Among 472 encounters, 55 (11.7%) had agitation requiring intervention.
Agitation requiring intervention incidence increased with score: 0, 3.3% (2/60); 1, 6.3% (6/96); 2, 6.4% (7/110); 3, 12.4% (17/137); 4, 31.8% (14/44); and 5, 36.0% (9/25).
Scores 4 to 5 had a specificity of at least 89% and a positive predictive value of greater than 33%.
Compared with scores 0 to 2, relative risk of agitation requiring intervention was 2.2 (95% CI, 1.1-4.3) for score 3 and 5.9 (95% CI, 3.3-10.7) for scores 4 to 5.
In pediatric emergency department mental and behavioral health encounters, the nurse-completed triage Brief Rating of Aggression in Children and Adolescents-Short demonstrated moderate discrimination and identified clinically meaningful risk gradients for agitation requiring intervention that may support early safety planning.