Refining triage practices by predicting the need for emergent care following major trauma: the experience of a level 1 adult trauma center.
Acute care
Emergency department
Multi-trauma
Trauma activation criteria
Journal
European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
20
09
2022
accepted:
01
12
2022
medline:
25
8
2023
pubmed:
16
12
2022
entrez:
15
12
2022
Statut:
ppublish
Résumé
We examined the predictability of selected parameters for establishing the need for urgent care following multi-trauma as a means to warrant the highest level of trauma activation and potentially improve over- and under-triage rates. In this retrospective cohort study of multi-trauma patients aged ≥ 16 years performed at a level 1 trauma center, trauma activation criteria and additional characteristics were examined with respect to treatment urgency, defined as: a direct disposition to the operating room or intensive care unit, initiating acute intervention in the trauma room, and in-hospital death within 7 days of admission. We enrolled 1373 patients (median age 36.0 years). The following parameter were inserted into the final multivariable model: age > 75 years, male sex, Charlson comorbidity index, trauma circumstances and mechanism, signs of respiratory distress, systolic BP ≤ 110 and GCS ≤ 13. Adjusted independent predictors of acute care requirement were as follows: GCS ≤ 13 (aOR 5.27 [95% CI 3.45-8.05], p < 0.001), systolic BP ≤ 110 mmHg (aOR 2.15 [95% CI 1.45-3.21], p < 0 .001), respiratory distress (aOR 2.05 [95% CI 1.53-2.77], p < 0.001), and age ≥ 75 years (aOR 1.90 [95% CI 1.18-3.08], p = 0.008). A GCS ≤ 13, systolic BP < 110 mmHg, signs of respiratory distress, and age > 75 years best predicted the need for acute care following multisystem trauma. Prospective studies are warranted to confirm the predictability of these criteria and to assess the extent to which their implementation will refine over- and under-triage rates.
Identifiants
pubmed: 36522466
doi: 10.1007/s00068-022-02195-4
pii: 10.1007/s00068-022-02195-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1717-1725Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
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