Outcome assessment of blunt trauma patients who are undertriaged

Surgery
Robert A CherryDavid T Mauger

Abstract

We investigated the outcomes of injured patients who were undertriaged and compared them with those meeting full trauma team activation (TTA) criteria. Blunt trauma patients (July 2002-January 2008) meeting full TTA criteria and had a partial TTA were in the undertriage group (UTG). Data was collected on demographics, injury severity, OR delays, resource utilization, and outcomes. Excluded: penetrating trauma, transfers, burns, age <18 years. Chi square, P < .05, mean +/- SD. One thousand four hundred and twenty-four patients with 318 (22.3%) in the UTG and 1,106 in the correctly triaged group (CTG). The CTG was 70.4% male (vs 67.1%; P = .26), 41.5 +/- 19.8 years old (vs 45.8 +/- 20.5; P < .01), and had an injury severity score (ISS) of 24.7 (vs 17.0; P < .0001). The CTG was more likely to require ED intubation (34.9% vs 8.2%; P < .0001), ICU admission (49.0% vs 37.1%; P < .0001), longer ICU/hospital LOS, and more ventilator days (P < .0001) with no differences in OR delays. The UTG had a lower mortality (6.0% vs 16.7%; P < .0001) and were discharged home more often (65.3% vs 52.2%; P = .02). The UTG had a lower ISS and improved outcomes compared to the CTG with no differences in OR delays. Despite inherent challenges in TTA pr...Continue Reading

References

Sep 1, 1988·Annals of Emergency Medicine·R KnoppL Doehring
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Nov 1, 1995·The Journal of Trauma·M J Zimmer-GembeckD D Trunkey
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Jun 28, 2006·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Robert C Mackersie
Aug 19, 2007·The Journal of Trauma·Robert A CherryRobert N Cooney
Dec 25, 2007·Journal of the American College of Surgeons·David J CieslaMarion H Jordan
Aug 20, 2008·Archives of Surgery·David C ChangEllen J Mackenzie
Jan 16, 2009·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Akkie N RingburgInger B Schipper

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Citations

Dec 1, 2013·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·A RogersJ A Miller
Feb 6, 2016·Journal of the American College of Surgeons·Brian G HarbrechtJ David Richardson
May 31, 2012·The American Surgeon·Amelia RogersMichael Horst
Feb 25, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Zohre NajafiAmir Mirhaghi
Sep 26, 2012·The Journal of Trauma and Acute Care Surgery·Gabriel E RybSandra Marie Waak

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