Accuracy of algorithms to predict injury severity in older adults for trauma triage

Hartka, Thomas; Gancayco, Christina; McMurry, Timothy L.; Robson, Marina; Weaver, Ashley A.

doi:10.1080/15389588.2019.1688795

Cited by 6 publications

(8 citation statements)

References 30 publications

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“…Six of these studies reported LRs, with older age cutoffs more frequently having higher LR+ for serious injury or mortality (Figure 2). 33,36,37,45,48,49 One of these studies evaluated unadjusted odds and two studies evaluated the aOR for mortality by age, finding higher odds (95% CI) of mortality as age increased from ≥44 years (OR 2.72 [1.07–6.92] vs. age < 44 years) 50 to ≥60 years (aOR 4.53 [4.03–5.09] vs. age < 60 years), 45 65–79 years (aOR 4.55 [4.25–4.87] vs. age 15–39 years), 19 or for ≥80 years (aOR 11.06 [10.17–12.04] vs. age 15–39 years) 19 . One study found that patients who are older (>65 years) were more likely to be undertriaged despite having high‐risk features for injury, but this study did not assess impacts of this undertriage on patient injury severity 51 .…”

Section: Resultsmentioning

confidence: 99%

“…Graphical representation of the LR+ for serious injury and mortality by age cutoff. Included studies were those reporting the positive LR for serious injury or mortality by patient age 33,36,37,45,48,49 …”

Section: Resultsmentioning

confidence: 99%

“…We performed a systematic review of the literature on the utility of mechanism and special consideration criteria for predicting serious injury in the prehospital triage of trauma patients since the 19,45,48,49 and indicated interactions between age and mechanism 16,17,33,35,36 as they relate to risk of serious injury. For example, pediatric patients (≤15 years old) not meeting physiologic or anatomic criteria had a comparable likelihood of trauma center need for lower impact falls (>10 ft, LR+ 5.9) 17 to adults (≥18 years old) not meeting physiologic and anatomic criteria, who had a comparable likelihood of trauma center need (LR+ 5.2) for falls from a greater height (>20 ft).…”

Section: Discussionmentioning

confidence: 99%

“…Six of these studies reported LRs, with older age cutoffs more frequently having higher LR+ for serious injury or mortality (Figure 2). 33,36,37,45,48,49 patients who are older (>65 years) were more likely to be undertriaged despite having high-risk features for injury, but this study did not assess impacts of this undertriage on patient injury severity. 51 A final study evaluated the odds for mortality comparing adults ≥ 70 years to adults < 70 years, finding higher unadjusted odds of inhospital mortality in older adults after being a pedestrian hit by a car or a fall with traumatic brain injury.…”

Section: Patient Agementioning

confidence: 97%

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Mechanism of injury and special considerations as predictive of serious injury: A systematic review

Lupton

Davis-OʼReilly

Jungbauer

et al. 2022

Academic Emergency Medicine

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Objectives:The Centers for Disease Control and Prevention's field triage guidelines (FTG) are routinely used by emergency medical services personnel for triaging injured patients. The most recent (2011) FTG contains physiologic, anatomic, mechanism, and special consideration steps. Our objective was to systematically review the criteria in the mechanism and special consideration steps that might be predictive of serious injury or need for a trauma center. Methods:We conducted a systematic review of the predictive utility of mechanism and special consideration criteria for predicting serious injury. A research librarian searched in Ovid Medline, EMBASE, and the Cochrane databases for studies published between January 2011 and February 2021. Eligible studies were identified using a priori inclusion and exclusion criteria. Studies were excluded if they lacked an outcome for serious injury, such as measures of resource use, injury severity scores, mortality, or composite measures using a combination of outcomes. Given the heterogeneity in populations, measures, and outcomes, results were synthesized qualitatively focusing | 1107 LUPTON et al.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Patient Agementioning

confidence: 97%

See 2 more Smart Citations

Mechanism of injury and special considerations as predictive of serious injury: A systematic review

Lupton

Davis-OʼReilly

Jungbauer

et al. 2022

Academic Emergency Medicine

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“…Age is not always synonymous with frailty which has also been found to play a major role in outcomes after trauma [ 11 ]. With increasing age, it becomes harder to predict the outcome after traumatic injury accurately [ 132 ]. Whilst the fatality rate is falling in younger patients (5.5%), it has not fallen (17.3%) and may even be increasing in older patients [ 133 ].…”

Section: Resultsmentioning

confidence: 99%

Challenges in the PREHOSPITAL emergency management of geriatric trauma patients – a scoping review

Eichinger

Robb

Scurr

et al. 2021

Scand J Trauma Resusc Emerg Med

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Background Despite a widely acknowledged increase in older people presenting with traumatic injury in western populations there remains a lack of research into the optimal prehospital management of this vulnerable patient group. Research into this cohort faces many uniqu1e challenges, such as inconsistent definitions, variable physiology, non-linear presentation and multi-morbidity. This scoping review sought to summarise the main challenges in providing prehospital care to older trauma patients to improve the care for this vulnerable group. Methods and findings A scoping review was performed searching Google Scholar, PubMed and Medline from 2000 until 2020 for literature in English addressing the management of older trauma patients in both the prehospital arena and Emergency Department. A thematic analysis and narrative synthesis was conducted on the included 131 studies. Age-threshold was confirmed by a descriptive analysis from all included studies. The majority of the studies assessed triage and found that recognition and undertriage presented a significant challenge, with adverse effects on mortality. We identified six key challenges in the prehospital field that were summarised in this review. Conclusions Trauma in older people is common and challenges prehospital care providers in numerous ways that are difficult to address. Undertriage and the potential for age bias remain prevalent. In this Scoping Review, we identified and discussed six major challenges that are unique to the prehospital environment. More high-quality evidence is needed to investigate this issue further.

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A vehicle occupant injury prediction algorithm based on road crash and emergency medical data

Nishimoto,

Kubota,

Ponte

2024

Journal of Safety Research

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Accuracy of algorithms to predict injury severity in older adults for trauma triage

Cited by 6 publications

References 30 publications

Mechanism of injury and special considerations as predictive of serious injury: A systematic review

Mechanism of injury and special considerations as predictive of serious injury: A systematic review

Challenges in the PREHOSPITAL emergency management of geriatric trauma patients – a scoping review

A vehicle occupant injury prediction algorithm based on road crash and emergency medical data

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