Trauma Team Activation Criteria as Predictors of Patient Disposition from the Emergency Department

Kohn, Michael A.; Hammel, Jean M.; Bretz, Stephen W; Stangby, Ann

doi:10.1111/j.1553-2712.2004.tb01364.x

Cited by 75 publications

(34 citation statements)

References 42 publications

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“…Our research, however, has several limitations. First, due to the nature of NEDS, we used only a single measure, head Abbreviate Injury Score [23], while others have used physiologic criteria as well as resources and interventions required during trauma patient care to identify severe injuries [24]. However, head injury AIS directly correlates with trauma patient mortality and is a common criterion for identifying severe head injury by previous researchers.…”

Section: Discussionmentioning

confidence: 99%

U.S. Trends of ED Visits for Pediatric Traumatic Brain Injuries: Implications for Clinical Trials

Chen

Shi

Stanley

et al. 2017

IJERPH

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Our goal in this paper was to use the 2006–2013 Nationwide Emergency Department Sample (NEDS) database to describe trends of annual patient number, patient demographics and hospital characteristics of pediatric traumatic brain injuries (TBI) treated in U.S. emergency departments (EDs); and to use the same database to estimate the available sample sizes for various clinical trials of pediatric TBI cases. National estimates of patient demographics and hospital characteristics were calculated for pediatric TBI. Simulation analyses assessed the potential number of pediatric TBI cases from randomly selected hospitals for inclusion in future clinical trials under different scenarios. Between 2006 and 2013, the NEDS database estimated that of the 215,204,932 children who visited the ED, 6,089,930 (2.83%) had a TBI diagnosis. During the study period in the US EDs, pediatric TBI patients increased by 34.1%. Simulation analyses suggest that hospital EDs with annual TBI ED visits >1000, Levels I and II Trauma Centers, pediatric hospitals, and teaching hospitals will likely provide ample cases for pediatric TBI studies. However, recruiting severe pediatric TBI cases for clinical trials from a limited number of hospital EDs will be challenging due to small sample sizes. Pediatric TBI-related ED visits in the U.S. increased by over 30% from 2006 to 2013. Including unspecified head injury cases with ICD-9-CM code 959.01 would significantly change the national estimates and demographic patterns of pediatric TBI cases. Future clinical trials of children with TBI should conduct a careful feasibility assessment to estimate their sample size and study power in selected study sites.

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Section: Discussionmentioning

confidence: 99%

U.S. Trends of ED Visits for Pediatric Traumatic Brain Injuries: Implications for Clinical Trials

Chen

Shi

Stanley

et al. 2017

IJERPH

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“…One of the main aims of prehospital care is to transport trauma patients safely to the most appropriate level of care as soon as the situation allows 2 3. Vital signs measured in the prehospital setting form part of ED trauma team activation criteria in use internationally despite being poor at predicting mortality, and better markers of physiological disturbance are needed 1 4 5. The shock index (SI) has been reported as possibly such a marker 6.…”

Section: Introductionmentioning

confidence: 99%

The value of the difference between ED and prehospital vital signs in predicting outcome in trauma

et al. 2013

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“…[24][25][26][27][28][29] However, there is a paucity of studies deriving criteria for the interhospital transfer of injured patients initially presenting to non-tertiary care facilities. In rural hospital emergency departments (EDs), early identification of patients requiring interhospital transfer for higher level of care services is a critical component of trauma systems that aspire to assure optimal care to both rural and urban citizens.…”

mentioning

confidence: 99%

Derivation of a clinical decision rule to guide the interhospital transfer of patients with blunt traumatic brain injury

Newgard

2005

Emergency Medicine Journal

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Objective: To derive a clinical decision rule for people with traumatic brain injury (TBI) that enables early identification of patients requiring specialised trauma care. Methods: We collected data from 1999 through 2003 on a retrospective cohort of consecutive people aged 18-65 years with a serious head injury (AIS >3), transported directly from the scene of injury, and evaluated in the ED. Information on 22 demographical, physiological, radiographic, and lab variables was collected. Resource based ''high therapeutic intensity'' measures occurring within 72 hours of ED arrival (the outcome measure) were identified a priori and included: neurosurgical intervention, exploratory laparotomy, intensive care interventions, or death. We used classification and regression tree analysis to derive and cross validate the decision rule. Results: 504 consecutive trauma patients were identified as having a serious head injury: 246 (49%) required at least one of the HTI measures. Five ED variables (GCS, respiratory rate, age, temperature, and pulse rate) identified subjects requiring at least one of the HTI measures with 94% sensitivity (95% CI 91 to 97%) and 63% specificity (95% CI 57 to 69%) in the derivation sample, and 90% sensitivity and 55% specificity using cross validation. Conclusions: This decision rule identified among a cohort of head injured patients evaluated in the ED the majority of those who urgently required specialised trauma care. The rule will require prospective validation in injured people presenting to non-tertiary care hospitals before implementation can be recommended.

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Trauma Team Activation Criteria as Predictors of Patient Disposition from the Emergency Department

Cited by 75 publications

References 42 publications

U.S. Trends of ED Visits for Pediatric Traumatic Brain Injuries: Implications for Clinical Trials

U.S. Trends of ED Visits for Pediatric Traumatic Brain Injuries: Implications for Clinical Trials

The value of the difference between ED and prehospital vital signs in predicting outcome in trauma

Derivation of a clinical decision rule to guide the interhospital transfer of patients with blunt traumatic brain injury

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