Fernandez Antonio R, Bourn Scott S, Hall Garrett D, Crowe Remle P, Myers J Brent
ESO, Austin, Texas.
J Trauma Nurs. 2023;30(1):5-13. doi: 10.1097/JTN.0000000000000691.
The Centers for Disease Control and Prevention Guidelines for Field Triage of Injured Patients drive the destination decision for millions of emergency medical services (EMS)-transported trauma patients annually, yet limited information exists regarding performance and relationship with patient outcomes as a whole.
To evaluate the association of positive findings on Centers for Disease Control and Prevention Guidelines for Field Triage of Injured Patients with hospitalization and mortality.
This retrospective study included all 911 responses from the 2019 ESO Data Collaborative research dataset with complete Centers for Disease Control and Prevention Guidelines for Field Triage of Injured Patients and linked emergency department dispositions, excluding children and cardiac arrests prior to EMS arrival. Patients were categorized by Centers for Disease Control and Prevention Guidelines for Field Triage of Injured Patients step(s) met. Outcomes were hospitalization and emergency department or inhospital mortality.
There were 86,462 records included: n = 65,967 (76.3%) met no criteria, n = 16,443 (19.0%) met one step (n = 1,571 [9.6%] vitals, n = 1,030 [6.3%] anatomy of injury, n = 993 [6.0%] mechanism of injury, and n = 12,849 [78.1%] special considerations), and n = 4,052 (4.7%) met multiple. Compared with meeting no criteria, hospitalization odds increased threefold for vitals (odds ratio [OR]: 3.07, 95% confidence interval [CI]: 2.77-3.40), fourfold for anatomy of injury (OR: 3.94, 95% CI: 3.48-4.46), twofold for mechanism of injury (OR: 2.00, 95% CI: 1.74-2.29), or special considerations (OR: 2.46, 95% CI: 2.36-2.56). Hospitalization odds increased ninefold when positive in multiple steps (OR: 8.97, 95% CI: 8.37-9.62). Overall, n = 84,473 (97.7%) had mortality data available, and n = 886 (1.0%) died. When compared with meeting no criteria, mortality odds increased 10-fold when positive in vitals (OR: 9.58, 95% CI: 7.30-12.56), twofold for anatomy of injury (OR: 2.34, 95% CI: 1.28-4.29), or special considerations (OR: 2.10, 95% CI: 1.71-2.60). There was no difference when only positive for mechanism of injury (OR: 0.22, 95% CI: 0.03-1.54). Mortality odds increased 23-fold when positive in multiple steps (OR: 22.7, 95% CI: 19.7-26.8).
Patients meeting multiple Centers for Disease Control and Prevention Guidelines for Field Triage of Injured Patients steps were at greater risk of hospitalization and death. When meeting only one step, anatomy of injury was associated with greater risk of hospitalization; vital sign criteria were associated with greater risk of mortality.
美国疾病控制与预防中心的《受伤患者现场分诊指南》每年指导着数百万由紧急医疗服务（EMS）转运的创伤患者的目的地决策，但关于其整体表现以及与患者预后的关系的信息有限。
评估美国疾病控制与预防中心《受伤患者现场分诊指南》中的阳性发现与住院和死亡率之间的关联。
这项回顾性研究纳入了2019年ESO数据协作研究数据集中所有911响应，这些响应具有完整的美国疾病控制与预防中心《受伤患者现场分诊指南》以及相关的急诊科处置情况，不包括儿童和EMS到达前的心脏骤停患者。根据满足美国疾病控制与预防中心《受伤患者现场分诊指南》的步骤对患者进行分类。结局指标为住院情况以及急诊科或住院期间的死亡率。
共纳入86462条记录：n = 65967（76.3%）未满足任何标准，n = 16443（19.0%）满足一个步骤（n = 1571 [9.6%]生命体征，n = 1030 [6.3%]损伤解剖学，n = 993 [6.0%]损伤机制，n = 12849 [78.1%]特殊考虑因素），n = 4052（4.7%）满足多个步骤。与未满足任何标准相比，生命体征阳性时住院几率增加三倍（比值比[OR]：3.07，95%置信区间[CI]：2.77 - 3.40），损伤解剖学阳性时增加四倍（OR：3.94，95% CI：
