Zohre Najafi1, Abbas Abbaszadeh2, Hossein Zakeri3, Amir Mirhaghi4. 1. Department of Nursing, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2. Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 3. Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 4. Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. mirhaghi@mail.com.
Abstract
PURPOSE: Mis-triage including undertriage and overtriage is associated with morbidity and mortality. It is not clear what the extent of mis-triage rates among traumatic patients is. The aim of this study is to determine of mis-triage (undertriage and overtriage) in traumatic patients. METHODS: This study was a systematic review about mis-triage rate among trauma patients. The following electronic databases were searched (Web of Knowledge, Scoups, PubMed, Cochrane library) from conception through February 1, 2018. Search terms included trauma, undertriage, and over-triage. Inclusion criteria were studies which report overtriage or undertriage rate in regard to triage of trauma patients; patients older than 18 years old, English-written papers. Irrelevant papers as well as conference abstract, letter, editorial, thesis and studies on special population were excluded. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Checklist was used to examine review process. RESULTS: Twenty-one papers were included in this study. Sample size ranged from 244 to 550683 trauma patients. Fourteen studies originated from USA. Definition of mis-triage was summarized into four categories: ISS used to define undertriage error, formula for mis-triage (1-sensitivity), need for life-saving emergency intervention and patients triaged to a non-trauma center. Undertriage rate ranged from 1 to 71.9% and overtriage rate ranged from 19 to 79%. CONCLUSIONS: The standardization of mis-triage definitions is vital to estimate true rate of mis-triage among different studies and clarify the role of triage scales. The trauma triage scales need to be further developed to provide more valid and reliable results.
PURPOSE: Mis-triage including undertriage and overtriage is associated with morbidity and mortality. It is not clear what the extent of mis-triage rates among traumaticpatients is. The aim of this study is to determine of mis-triage (undertriage and overtriage) in traumaticpatients. METHODS: This study was a systematic review about mis-triage rate among traumapatients. The following electronic databases were searched (Web of Knowledge, Scoups, PubMed, Cochrane library) from conception through February 1, 2018. Search terms included trauma, undertriage, and over-triage. Inclusion criteria were studies which report overtriage or undertriage rate in regard to triage of traumapatients; patients older than 18 years old, English-written papers. Irrelevant papers as well as conference abstract, letter, editorial, thesis and studies on special population were excluded. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Checklist was used to examine review process. RESULTS: Twenty-one papers were included in this study. Sample size ranged from 244 to 550683 traumapatients. Fourteen studies originated from USA. Definition of mis-triage was summarized into four categories: ISS used to define undertriage error, formula for mis-triage (1-sensitivity), need for life-saving emergency intervention and patients triaged to a non-trauma center. Undertriage rate ranged from 1 to 71.9% and overtriage rate ranged from 19 to 79%. CONCLUSIONS: The standardization of mis-triage definitions is vital to estimate true rate of mis-triage among different studies and clarify the role of triage scales. The trauma triage scales need to be further developed to provide more valid and reliable results.
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