OBJECTIVE: To evaluate the efficiency (sensitivity, specificity, positive predictive value, overtriage, and undertriage) of activation of the trauma team in a Norwegian trauma referral centre. DESIGN: A cohort study with univariate and multivariate analysis. SETTING: A primary trauma hospital and trauma referral centre, Norway. SUBJECTS: 3391 injured patients admitted during a 12 months period, starting January 15th, 1996. MAIN OUTCOME MEASURES: Activation of the trauma team for severely injured patients and factors associated with correct activation. RESULTS: Of the 3383 injured patients admitted, 283 (8%) were classified as severely injured. Of 507 activations of the trauma team, 240 (47%) were for severely injured patients (sensitivity 85%, undertriage 15%, specificity 91%, overtriage 9%, positive predictive value 0.47). The system of activation was significantly more efficient for patients admitted by anaesthetist-manned ambulances than by ordinary ground ambulances (sensitivity 94% compared with 83%, corresponding positive predictive value 0.55 and 0.33, p < 0.05). Female sex and age over 70 years were independent factors associated with significantly less use of the trauma team in severely injured patients (p < 0.05). CONCLUSION: The undertriage rate of 15% and a positive predictive value of only 0.47 indicates a need for improvement of our activation system. Female sex and age over 70 years were significantly associated with undertriage in severely injured patients. Our protocol for triage and the initial treatment of severely injured patients has been revised in the light of these findings, and we have established a trauma registry.
OBJECTIVE: To evaluate the efficiency (sensitivity, specificity, positive predictive value, overtriage, and undertriage) of activation of the trauma team in a Norwegian trauma referral centre. DESIGN: A cohort study with univariate and multivariate analysis. SETTING: A primary trauma hospital and trauma referral centre, Norway. SUBJECTS: 3391 injured patients admitted during a 12 months period, starting January 15th, 1996. MAIN OUTCOME MEASURES: Activation of the trauma team for severely injured patients and factors associated with correct activation. RESULTS: Of the 3383 injured patients admitted, 283 (8%) were classified as severely injured. Of 507 activations of the trauma team, 240 (47%) were for severely injured patients (sensitivity 85%, undertriage 15%, specificity 91%, overtriage 9%, positive predictive value 0.47). The system of activation was significantly more efficient for patients admitted by anaesthetist-manned ambulances than by ordinary ground ambulances (sensitivity 94% compared with 83%, corresponding positive predictive value 0.55 and 0.33, p < 0.05). Female sex and age over 70 years were independent factors associated with significantly less use of the trauma team in severely injured patients (p < 0.05). CONCLUSION: The undertriage rate of 15% and a positive predictive value of only 0.47 indicates a need for improvement of our activation system. Female sex and age over 70 years were significantly associated with undertriage in severely injured patients. Our protocol for triage and the initial treatment of severely injured patients has been revised in the light of these findings, and we have established a trauma registry.
Authors: Kjetil Søreide; Andreas J Krüger; Anne Line Vårdal; Christian Lycke Ellingsen; Eldar Søreide; Hans Morten Lossius Journal: World J Surg Date: 2007-11 Impact factor: 3.352
Authors: Thomas Kristiansen; Hans M Lossius; Kjetil Søreide; Petter A Steen; Christine Gaarder; Pål A Næss Journal: J Trauma Manag Outcomes Date: 2011-06-16
Authors: Marius Rehn; Torsten Eken; Andreas Jorstad Krüger; Petter Andreas Steen; Nils Oddvar Skaga; Hans Morten Lossius Journal: Scand J Trauma Resusc Emerg Med Date: 2009-01-09 Impact factor: 2.953
Authors: Kjetil G Ringdal; Timothy J Coats; Rolf Lefering; Stefano Di Bartolomeo; Petter Andreas Steen; Olav Røise; Lauri Handolin; Hans Morten Lossius Journal: Scand J Trauma Resusc Emerg Med Date: 2008-08-28 Impact factor: 2.953