Outcomes of Patients Using a Tiered Trauma Response Protocol

Eastes, Lynn; Norton, Robert L.; Brand, Dawn; Pearson, S.; Mullins, Richard J.

doi:10.1097/00005373-200105000-00022

Cited by 48 publications

(35 citation statements)

References 7 publications

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“…Furthermore, the lower mortality rate and the shorter intensive care unit length of stay in the undertriaged patients likely reflect the significantly lower ISS and higher GCS in this population. This finding is similar to other studies that seek to find factors related to undertriage 28,29. Undertriaged patients tend to have lower injury scores than TTA patients, and thus are expected to have better outcomes overall.…”

Section: Discussionsupporting

confidence: 88%

Risk factors and mortality associated with undertriage at a level I safety-net trauma center: a retrospective study

Barsi

Harris

Menaik

et al. 2016

OAEM

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PurposeThe primary objective of this study was to determine the risk factors associated with undertriage and the risk factors for mortality among the undertriaged patients at a level I safety-net trauma center.MethodsA retrospective analysis was performed of all trauma patients who presented to a level I safety-net trauma center with an injury severity score >15 over a 2-year period (2013–2014). Univariate and multivariate regression analyses were used to determine the risk factors predictive of undertriage in major trauma patients (injury severity score >15) and of mortality in undertriaged patients.ResultsDuring the 2-year study period, 334 of 2,485 admitted trauma patients presented with major trauma and were included in our study. From the univariate analysis, variables that were found to be independently associated with mortality in undertriaged patients included intubation, Glasgow Coma Scale score, revised trauma score, and dementia. Independent risk factors that were found to be significantly associated with undertriage in severely injured trauma patients included Glasgow Coma Scale score, motor vehicle crash, falls, revised trauma score, systolic blood pressure, heart rate, intubation, and dementia. When a multivariate analysis was performed to evaluate the statistically significant risk factors, dementia was found to be significantly associated with undertriage in severely injured trauma patients.ConclusionSeverely injured trauma patients with dementia are at significant risk for undertriage. Early identification of these risk factors while triaging at a level I safety-net trauma center could translate into improved patient outcomes following severe trauma.

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Section: Discussionsupporting

confidence: 88%

Risk factors and mortality associated with undertriage at a level I safety-net trauma center: a retrospective study

Barsi

Harris

Menaik

et al. 2016

OAEM

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“…Using several response levels, multispecialty teams (when severe injuries and abnormal vital signs are identified), and smaller teams for stable trauma patients promote better resource utilization [37]. In patients with minor to moderate injury, rapid trauma workup is still important, as occult injuries may exist, but it may still not mandate a full trauma team.…”

Section: Discussionmentioning

confidence: 99%

Differences in trauma team activation criteria among Norwegian hospitals

Larsen

Uleberg

Skogvoll

2010

Scand J Trauma Resusc Emerg Med

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BackgroundTo ensure the rapid and correct triage of patients in potential need of specialized treatment, Norwegian hospitals are expected to establish trauma teams with predefined criteria for their activation. The objective of this study was to map and describe the criteria currently in use.MethodsWe undertook a cross-sectional survey in the summer of 2008, using structured telephone interviews to all Norwegian hospitals that might admit severely injured patients.ResultsForty-nine hospitals were included, of which 48 (98%) had a trauma team and 20 had a hospital-based trauma registry. Criteria for trauma team activation were found at 46 (94%) hospitals. No single criterion was common to all hospitals. The median number of criteria per hospital was 23 (range 8-40), with a total number of 156 and wide variation with respect to physiological "cut-off" values. The mechanism of injury was commonly in use despite a well-known, large over-triage rate.ConclusionsIn recent years, Norwegian hospitals have gradually established trauma teams and criteria for their activation. These criteria show considerable variation, including physiological "cut-off" values.

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“…Other authors, with smaller numbers of patients, have also reported success with similar systems. Eastes et al 7 compared patient outcomes for a 2-year period before and after establishing a two-tier team response and compared these data with a case-control group who had been undertriaged. They used 10 physiologic and anatomic factors in the triage decision.…”

Section: Discussionmentioning

confidence: 99%