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Field trauma triage: combining mechanism of injury with the prehospital index for an improved trauma triage tool



Field trauma triage: combining mechanism of injury with the prehospital index for an improved trauma triage tool



Journal of Trauma 43(2): 283-287



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 gtoreq 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 mchgt 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 ltoreq 5 0.001). Conclusion: The combined PHI/MOI score was better at identifying those patients with ISS scores a 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.

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Accession: 008685832

Download citation: RISBibTeXText

PMID: 9291374


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