A. Fulginiti4, A. Jambhekar1, Z. Nasrawi2, V. Chan3, B. Fahoum2, J. Rucinski2 1Columbia University College Of Physicians And Surgeons,Breast Surgery Division,New York, NY, USA 2New York Presbyterian Brooklyn Methodist Hospital,Department Of Surgery,Brooklyn, NY, USA 3Abington Memorial Hospital,Department Of Medicine,Abington, PA, USA 4Monmouth Medical Center,Department Of Obstetrics/Gynecology,Long Branch, NJ, USA
Introduction: The American College of Surgeons (ACS) provides guidelines for the triage of patients at Trauma Centers. Several studies have shown that activations based on mechanism have been ineffective at predicting patient outcome. The objective of our study is to evaluate injury severity in overtriaged blunt trauma activations based on mechanism.
Methods: Data was prospectively gathered on 1,298 blunt trauma patients from April 1st 2015 to December 31st 2016. Patients over 14 years old who were overtriaged as a level one or two activation (n=153) were compared to trauma consults (n=1145) by age, injury severity score (ISS), length of stay (LOS), time to evaluation and mechanism of injury using the unpaired Student T Test and Chi Square analysis.
Results: Overall, 11.79% of patients were overtriaged, most involving motor vehicle or bicycle related trauma (Table 1). The age (years), LOS (days), and time to evaluation (hours) of overtriaged patients were significantly decreased compared to consults. The ISS scores were similar. There were no missed injuries.
Conclusion: Patients who were overtriaged by mechanism of injury underwent earlier evaluation although the ISS was similar and hospital stay was shorter than trauma consult patients. Based on these results, mechanism of injury is not an accurate predictor of outcome in blunt trauma patients. More stringent application of the ACS trauma triage guidelines may lead to optimal use of trauma team resources.
