Cottington E M, Young J C, Shufflebarger C M, Kyes F, Peterson F V, Diamond D L
Allegheny-Singer Research Institute, Pittsburgh, PA 15212-9986.
J Trauma. 1988 Mar;28(3):305-11. doi: 10.1097/00005373-198803000-00005.
It has been suggested that if triage criteria are to identify accurately patients with major trauma, not only physiologic status, but also anatomic site and injury mechanism must be assessed. This study examined the influence of physiologic, injury site, and injury mechanism criteria on the diagnosis of major trauma in 2,057 trauma patients. Because the Trauma Score was found to be a highly specific indicator of major trauma (98.7%), the strategy adopted for isolating the factors that minimize inappropriate triage was to determine which, alone or in combination, are the most effective in identifying patients with major trauma among those with high Trauma Scores (greater than 12). Based on this analysis, a set of triage guidelines was developed. The application of these guidelines to the study population indicated an undertriage rate of 4.1 to 6.3% and an overtriage rate of 16.8 to 21.3%, depending on the definition of major trauma.
有人提出，如果分诊标准要准确识别出严重创伤患者，那么不仅要评估生理状态，还必须评估解剖部位和损伤机制。本研究调查了生理、损伤部位和损伤机制标准对2057例创伤患者严重创伤诊断的影响。由于发现创伤评分是严重创伤的高度特异性指标（98.7%），用于分离使不适当分诊最小化的因素的策略是确定哪些因素单独或联合起来，在创伤评分高（大于12）的患者中识别严重创伤患者最为有效。基于这一分析，制定了一套分诊指南。将这些指南应用于研究人群表明，根据严重创伤的定义，漏诊率为4.1%至6.3%，误诊率为16.8%至21.3%。
