Baxt W G, Jones G, Fortlage D
Department of Emergency Medicine, UCSD Medical Center 92103-1990.
Ann Emerg Med. 1990 Dec;19(12):1401-6. doi: 10.1016/s0196-0644(05)82608-3.
To develop a new trauma decision rule.
Retrospective clinical review.
Level I trauma center.
1,004 injured adults.
A new trauma decision rule was derived from 1,004 injured adult patients using a new operational definition of major trauma. The rule, termed the Trauma Triage Rule, defines a major trauma victim as any injured adult patient whose systolic blood pressure is less than 85 mm Hg; whose motor component of the Glasgow Coma Score is less than 5; or who has sustained penetrating trauma of the head, neck, or trunk. Using the operational definition of major trauma, the rule had a sensitivity of 92% and a specificity of 92% when tested on the 1,004-patient cohort.
The Trauma Triage Rule may significantly reduce overtriage while only minimally increasing undertriage. This approach must be validated prospectively before it can be used in the prehospital setting.
制定一项新的创伤决策规则。
回顾性临床研究。
一级创伤中心。
1004名成年伤者。
采用新的重伤定义，从1004名成年伤者中得出一项新的创伤决策规则。该规则称为创伤分诊规则，将重伤患者定义为收缩压低于85毫米汞柱的成年伤者；格拉斯哥昏迷评分运动部分低于5分的成年伤者；或头部、颈部或躯干遭受穿透性创伤的成年伤者。根据重伤的操作定义，该规则在1004名患者队列中进行测试时，灵敏度为92%，特异度为92%。
创伤分诊规则可能显著减少过度分诊，同时仅略微增加漏诊。在院前环境中使用此方法之前，必须进行前瞻性验证。
