Husum Hans, Gilbert Mads, Wisborg Torben, Van Heng Yang, Murad Mudhafar
Department of Anesthesiology, Institute of Clinical Medicine, University Hospital of Northern Norway, Tromsoe.
J Trauma. 2003 Sep;55(3):466-70. doi: 10.1097/01.TA.0000044634.98189.DE.
Where trauma systems do not exist, such as in low-income countries, the aim of prehospital triage is identification of trauma victims with high priority for forward resuscitation. The present pilot study explored the accuracy of simple prehospital triage tools in the hands of nongraduate trauma care providers in the minefields of North Iraq and Cambodia.
Prehospital prediction of trauma death and major trauma victims (Injury Severity Score > 15) was studied in 737 adult patients with penetrating injuries and long evacuation times (mean, 6.1 hours).
Both the respiratory rate and the full Physiologic Severity Score predicted trauma death with high accuracy (area under the curve for receiver-operating characteristic plots at 0.9) and significantly better than other physiologic indicators. The accuracy in major trauma victim identification was moderate for all physiologic indicators (area under the receiver-operating characteristic curve, 0.7-0.8).
Respiratory rate > 25 breaths/min may be a useful triage tool for nongraduate trauma care providers where the scene is chaotic and evacuations long. Further studies on larger cohorts are necessary to validate the results.
在一些没有创伤系统的地区，如低收入国家，院前分诊的目的是识别出需要优先进行进一步复苏的创伤患者。本试点研究探讨了在伊拉克北部和柬埔寨雷区，非专业创伤护理人员使用简单院前分诊工具的准确性。
对737例穿透伤且转运时间较长（平均6.1小时）的成年患者进行院前创伤死亡和重伤患者（损伤严重度评分>15）的预测研究。
呼吸频率和完整的生理严重度评分对创伤死亡的预测准确性较高（受试者工作特征曲线下面积为0.9），且显著优于其他生理指标。所有生理指标在识别重伤患者方面的准确性中等（受试者工作特征曲线下面积为0.7 - 0.8）。
呼吸频率>25次/分钟可能是现场混乱且转运时间长时，非专业创伤护理人员有用的分诊工具。需要对更大样本队列进行进一步研究以验证结果。
