BACKGROUND: The objective of this study was to combine a physiologic triage score (prehospital index, PHI) with criteria regarding mechanism of injury (MOI) to increase the efficacy of trauma triage. The specific question being asked was: will the combined score improve the sensitivity and specificity over that of the individual scores? METHODS: In this prospective study, 3,147 injury patients (all adults > or = 14 years) were reviewed. Each patient received a PHI score and a MOI score in the field, which were compared with their Injury Severity Score (ISS) at separation. An ISS > or = 16 was defined as major trauma. RESULTS: PHI alone had a sensitivity of 41%, MOI alone had a sensitivity of 73%, whereas the combined PHI/MOI score had a sensitivity of 78%. All three had similar specificities. These findings were statistically significant (p < or = 0.001). CONCLUSION: The combined PHI/MOI score was better at identifying those patients with ISS scores > or = 16 compared with the PHI and MOI scores alone. Although this permitted superior triage (and minimized overtriage), the combined score did not identify all major trauma patients.
BACKGROUND: The objective of this study was to combine a physiologic triage score (prehospital index, PHI) with criteria regarding mechanism of injury (MOI) to increase the efficacy of trauma triage. The specific question being asked was: will the combined score improve the sensitivity and specificity over that of the individual scores? METHODS: In this prospective study, 3,147 injurypatients (all adults > or = 14 years) were reviewed. Each patient received a PHI score and a MOI score in the field, which were compared with their Injury Severity Score (ISS) at separation. An ISS > or = 16 was defined as major trauma. RESULTS:PHI alone had a sensitivity of 41%, MOI alone had a sensitivity of 73%, whereas the combined PHI/MOI score had a sensitivity of 78%. All three had similar specificities. These findings were statistically significant (p < or = 0.001). CONCLUSION: The combined PHI/MOI score was better at identifying those patients with ISS scores > or = 16 compared with the PHI and MOI scores alone. Although this permitted superior triage (and minimized overtriage), the combined score did not identify all major traumapatients.
Authors: Craig D Newgard; Dana Zive; James F Holmes; Eileen M Bulger; Kristan Staudenmayer; Michael Liao; Thomas Rea; Renee Y Hsia; N Ewen Wang; Ross Fleischman; Jonathan Jui; N Clay Mann; Jason S Haukoos; Karl A Sporer; K Dean Gubler; Jerris R Hedges Journal: J Am Coll Surg Date: 2011-12 Impact factor: 6.113
Authors: E Brooke Lerner; Jeremy T Cushman; Alan Blatt; Richard D Lawrence; Manish N Shah; Robert A Swor; Karen Brasel; Gregory J Jurkovich Journal: Prehosp Emerg Care Date: 2011-08-04 Impact factor: 3.077
Authors: Craig D Newgard; Kyle Rudser; Jerris R Hedges; Jeffrey D Kerby; Ian G Stiell; Daniel P Davis; Laurie J Morrison; Eileen Bulger; Tom Terndrup; Joseph P Minei; Berit Bardarson; Scott Emerson Journal: J Trauma Date: 2010-02
Authors: Craig D Newgard; Gena K Sears; Thomas D Rea; Daniel P Davis; Ronald G Pirrallo; Clifton W Callaway; Dianne L Atkins; Ian G Stiell; Jim Christenson; Joseph P Minei; Carolyn R Williams; Laurie J Morrison Journal: Resuscitation Date: 2008-05-15 Impact factor: 5.262