Trauma and Acute Care Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Metropolitan Emergency Medical Services, Little Rock, AR, USA.
J Inj Violence Res. 2022 Jan;14(1):115-124. doi: 10.5249/jivr.v14i1.1650. Epub 2022 Feb 7.
The precision of emergency medical services (EMS) triage criteria dictates whether an injured patient receives appropriate care. The trauma triage protocol is a decision scheme that groups patients into triage categories of major, moderate and minor. We hypothesized that there is a difference between trauma triage category and injury severity score (ISS).
This retrospective, observational study was conducted to investigate a difference between trauma triage category and ISS. Bivariate analysis was used to test for differences between the subgroup means. The differences between the group means on each measure were analyzed for direction and statistical significance using ANOVA for continuous variables and chi square tests for categorical variables. Logistic and linear regressions were performed to evaluate factors predicting mortality, ICU length of stay.
With respect to trauma triage category, our findings indicate that minor and moderate triage categories are similar with respect to ISS, GCS, ICU LOS, hospital LOS, and mortality. However, after excluding for low impact injuries (falls), differences between the minor and moderate categories were evident when comparing to ISS, GCS, ICU LOS, and hospital LOS. Additionally, after excluding for low impact injures, ISS, ICU LOS, and hospital stay were found to correlate well with trauma triage category.
In this retrospective, observational study significant differences were not seen when comparing ISS with the trauma triage categories of moderate and minor during our initial analysis. However, a difference was found after excluding for low impact injuries. These findings suggest that CDC criteria accurately predicts outcomes in high impact trauma.
紧急医疗服务（EMS）分诊标准的精确性决定了受伤患者是否能得到适当的治疗。创伤分诊方案是一种决策方案，将患者分为主要、中度和轻度分诊类别。我们假设创伤分诊类别和损伤严重程度评分（ISS）之间存在差异。
本回顾性观察研究旨在探讨创伤分诊类别和 ISS 之间的差异。使用双变量分析来检验亚组均值之间的差异。使用方差分析（连续变量）和卡方检验（分类变量）分析每组均值之间的差异方向和统计学意义。进行逻辑回归和线性回归，以评估预测死亡率、ICU 住院时间的因素。
就创伤分诊类别而言，我们的研究结果表明，轻度和中度分诊类别在 ISS、GCS、ICU LOS、医院 LOS 和死亡率方面相似。然而，在排除低影响损伤（跌倒）后，轻度和中度类别之间在 ISS、GCS、ICU LOS 和医院 LOS 方面存在差异。此外，在排除低影响损伤后，ISS、ICU LOS 和住院时间与创伤分诊类别相关性良好。
在这项回顾性观察研究中，在最初的分析中，我们比较 ISS 与中度和轻度创伤分诊类别时没有发现显著差异。然而，在排除低影响损伤后，发现了差异。这些发现表明，CDC 标准可以准确预测高影响创伤的结局。
