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Objectives The aim of this study was to develop machine learning (ML) and initial nursing assessment (INA)-based emergency department (ED) triage to predict adverse clinical outcome. Methods The retrospective study included ED visits between January 2016 and December 2017 that resulted in either intensive care unit admission or emergency room death. We trained four classifiers using logistic regression and a deep learning model on INA and low dimensional (LD) INA, logistic regression on the Korea Triage and acuity scale (KTAS) and Seque