Prehospital triage and survival of major trauma patients in a Dutch regional trauma system: relevance of trauma registry

Sturms, Leontien M.; Hoogeveen, Josephine M.; Cessie, Saskia le; Schenck, P. E.; Pahlplatz, Paul V. M.; Hogervorst, Mike; Jukema, G. N.

doi:10.1007/s00423-006-0057-1

Cited by 21 publications

(14 citation statements)

References 22 publications

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“…The newly developed model had a sensitivity of 92% and would have identified 58% more major trauma patients than the currently used triage tool (Revised Trauma Score (RTS) <11) [11]. The overtriage rate (one minus specificity) of the new model was 21%.…”

Section: Discussionmentioning

confidence: 96%

“…First of all, we only included trauma patients treated in the level-one trauma center. A previous study indicated that the major trauma patients treated in non-trauma-center hospitals in our trauma system are less severely injured [11]. The degree to which the new triage model is able to correctly identify these patients needs to be investigated.…”

Section: Discussionmentioning

confidence: 99%

“…Probably all prehospital triage schemes in other countries that include the RTS will need to be adjusted in view of the small number of major trauma patients showing a lowered RTS in the prehospital setting [11].Trauma registries are indispensable for these kinds of evaluations. Likely, other regions or countries will adjust the triage model because of specific geographical differences, differences in available resources and expertise at the nontrauma-center hospitals, and differences in injury profiles.…”

Section: Discussionmentioning

confidence: 99%

“…For the identification of these patients, various prehospital triage guidelines have been developed to assist paramedic judgment [10]. Yet, only few studies have evaluated the performance of triage tools in European datasets [11][12][13]. In general, these studies have reported on poor performances and there is no consensus on which tool is best in identifying major trauma patients in the field.…”

Section: Introductionmentioning

confidence: 99%

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Prehospital identification of major trauma patients

Ocak

Sturms

Hoogeveen

et al. 2008

Langenbecks Arch Surg

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Background and aims Prehospital triage is aimed at getting the right patient to the right hospital. Evaluations on the performance of prehospital triage tools are scarce. This study examines the ability of the American College of Surgeons' Committee on Trauma (ACSCOT) triage guidelines to identify major trauma patients in a European trauma system. Furthermore, this study evaluates the predictive power of other prehospital measurements. Materials and methods Prehospital data of 151 minor (Injury Severity Score (ISS) 1-15) and 151 major trauma patients, (ISS>15) treated at a Dutch trauma center, were collected. Logistic regression analysis was used to identify predictors of major trauma patients. Results The major trauma patients particularly incurred severe head injuries (45.7%) and severe thorax injuries (21.9%). The ACSCOT guidelines had a sensitivity of 84.1% and a specificity of 77.5%. A new prehospital trauma triage model was constructed including nine predictors of major trauma. This model identified more major trauma patients than the ACSCOT (sensitivity 92.1%, p=0.023) and resulted in a comparable specificity (79.5%; p=0.711). Conclusion The new triage model outperforms the ACS COT triage guidelines in identifying major trauma patients in the prehospital setting. The new triage guidelines may improve patient outcomes but needs to be validated in a prospective study.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prehospital identification of major trauma patients

Ocak

Sturms

Hoogeveen

et al. 2008

Langenbecks Arch Surg

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“…A trauma registry will provide a large and longitudinal database for analysis,[ 13 ] and reliable information necessary for health policy and care delivery including pre-hospital care. [ 14 ] Trauma registries even in austere environments are likely to be valuable tools for developing the health care system, identifying priority areas for quality improvement, policy implementation gaps and relevant interventions. [ 15 ]…”

Section: Discussionmentioning

confidence: 99%

Direct (presenting primarily to trauma center) versus indirect (referred or transferred) admission of patients to the Trauma Centre of King George Medical University: One-year prospective pilot study

Verma

Singh

Kumar

et al. 2015

Int J Crit Illn Inj Sci

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Background:India does not have a trauma registry. There is lack of base line demographic data of trauma victims that present directly to the trauma center and those that are transferred to the trauma center.Aim:To compare the clinical and demographic profile of directly admitted (presenting primarily to the trauma center) and referred (transferred to trauma center) patients at the trauma centre of King George Medical University.Materials and Methods:The demographic and clinical profiles of patients admitted on thirty-three consecutive Mondays were collected and compared. In addition, the demographic data of patients admitted on Mondays and eight randomly selected Wednesdays and Saturdays were analyzed to ascertain the representativeness of the studied sample.Results:Of the 572 patients in the study, 327 were referred and 245 were directly admitted. There was 27% mortality in the referred group and 22% mortality in the directly admitted group, the difference been statistically insignificant (P value 0.20). Patients referred from peripheral hospitals were more severely injured with a lower GCS and a higher TRISS, and had a higher proportion of multi system major trauma and severe head injury.Conclusion:Referred admitted (transferred) patients at the KGMU trauma center are more seriously injured than the patients presenting directly. Yet there is no statistically significant difference in the overall mortality. A future study focusing on certain sub-categories of patients such as those demonstrating subdural hematoma, GCS less than 9 or ISS more than 15 may yield interesting data.

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