The accuracy of acuity scoring tools to predict 24-h mortality in traumatic brain injury patients: A guide to triage criteria

Najafi, Zohre; Zakeri, Hossien; Mirhaghi, Amir

doi:10.1016/j.ienj.2017.08.003

Cited by 17 publications

(14 citation statements)

References 29 publications

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“…The scales most studied are the Revised Trauma Score [36], the GCS [16,18] and different physiological and analytical parameters [37] or scores on spinal damage [38]. Najafi et al [39] analyzed the use of different scores to predict the risk of death within 24 hours, including the NEWS, offering our study (although with a mortality outcome within 48 hours) better AUROC, as well as better sensitivity and specificity.…”

Section: Comparison With Previous Studiesmentioning

confidence: 97%

“…Of all the EWS analyzed in this study, the NEWS2 [23] seems to be the most suitable for use in a prehospital setting. The NEWS2 is validated at prehospital level [52], its use is well-established in many clinical contexts [30,32,39], it only uses standard physiological parameters that can be determined at the scene or en route and may be used in both patients with trauma and those with a medical pathology [53,54]. To be able to calculate the TEWS [25], it is necessary to know whether the patient presents a trauma or not, and the mobility level, and the MREMS [24] uses age to obtain the scoring.…”

Section: Early Warning Scores (Ews) and Prehospital Tbimentioning

confidence: 99%

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Identification of Serious Adverse Events in Patients with Traumatic Brain Injuries, from Prehospital Care to Intensive-Care Unit, Using Early Warning Scores

Martin-Rodríguez

López-Izquierdo

Mohedano-Moriano

et al. 2020

IJERPH

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Traumatic brain injuries are complex situations in which the emergency medical services must quickly determine the risk of deterioration using minimal diagnostic methods. The aim of this study is to analyze whether the use of early warning scores can help with decision-making in these dynamic situations by determining the patients who need the intensive care unit. A prospective, multicentric cohort study without intervention was carried out on traumatic brain injury patients aged over 18 given advanced life support and taken to the hospital. Our study included a total of 209 cases. The total number of intensive-care unit admissions was 50 cases (23.9%). Of the scores analyzed, the National Early Warning Score2 was the best result presented with an area under the curve of 0.888 (0.81–0.94; p < 0.001) and an odds ratio of 25.4 (95% confidence interval (CI):11.2–57.5). The use of early warning scores (and specifically National Early Warning Score2) can help the emergency medical services to differentiate traumatic brain injury patients with a high risk of deterioration. The emergency medical services should use the early warning scores routinely in all cases for the early detection of high-risk situations.

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Section: Comparison With Previous Studiesmentioning

confidence: 97%

Section: Early Warning Scores (Ews) and Prehospital Tbimentioning

confidence: 99%

Identification of Serious Adverse Events in Patients with Traumatic Brain Injuries, from Prehospital Care to Intensive-Care Unit, Using Early Warning Scores

Martin-Rodríguez

López-Izquierdo

Mohedano-Moriano

et al. 2020

IJERPH

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show abstract

“…Previous studies showed that the vital signs are often not affected and may change over time. Patients suffering a head injury from low‐risk mechanisms of injury might present to the EMS providers with minimal symptoms, but develop alarming symptoms hours or days later . In this study, most patients with a head injury had a Glasgow Coma Scale (GCS) score between 12 and 15.…”

Section: Discussionmentioning

confidence: 88%

Diagnostic value of emergency medical services provider judgement in the identification of head injuries among trauma patients

Rein¹,

Jochems²,

Lokerman³

et al. 2018

Euro J of Neurology

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“…Previous studies have shown a lower compliance rate to the vital sign criteria [23,34,38]. This could be because the majority of the trauma patients have normal or near normal vital signs [39][40][41].…”

Section: Discussionmentioning

confidence: 99%

The role of emergency medical service providers in the decision-making process of prehospital trauma triage

Rein

Sadiqi

Lansink

et al. 2018

Eur J Trauma Emerg Surg

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Purpose Severely injured patients should be treated at higher-level trauma centres, to improve chances of survival and avert life-long disabilities. Emergency medical service (EMS) providers must try to determine injury severity on-scene, using a prehospital trauma triage protocol, and decide the most appropriate type of trauma centre. The objective of this study is to investigate the role of EMS provider judgment in the prehospital triage process of trauma patients, by analysing the compliance rate to the protocol and administering a questionnaire among EMS providers. Methods All trauma patients transported to a trauma centre in two different regions of the Netherlands were analysed. Compliance rate was based on the number of patients meeting the triage criteria and transported to the corresponding level trauma centre. The questionnaire was administered among EMS providers. Descriptive statistics were used to analyse the data. Results For adult patients, the compliance rate to the level I criteria of the triage protocol was 72% in Central Netherlands and 42% in Brabant. For paediatric patients, this was 63% and 38% in Central Netherlands and Brabant, respectively. The judgment on injury severity was mostly based on the injury-type criteria. Additionally, the distance to a level I trauma centre influenced the decision for destination facility in the Brabant region. Conclusion The compliance rate varied between regions. Improvement of prehospital trauma triage depends on the accuracy of the protocol and compliance rate. A new protocol, including EMS provider judgment, might be the key to improvement in the prehospital trauma triage quality.

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The accuracy of acuity scoring tools to predict 24-h mortality in traumatic brain injury patients: A guide to triage criteria

Cited by 17 publications

References 29 publications

Identification of Serious Adverse Events in Patients with Traumatic Brain Injuries, from Prehospital Care to Intensive-Care Unit, Using Early Warning Scores

Identification of Serious Adverse Events in Patients with Traumatic Brain Injuries, from Prehospital Care to Intensive-Care Unit, Using Early Warning Scores

Diagnostic value of emergency medical services provider judgement in the identification of head injuries among trauma patients

The role of emergency medical service providers in the decision-making process of prehospital trauma triage

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