Doctors For You, Mumbai, India.
World Health Organization Collaborating Center for Research in Surgical Care Delivery in Low-and-Middle Income Countries, Mumbai, India.
BMJ Open. 2023 May 8;13(5):e065036. doi: 10.1136/bmjopen-2022-065036.
To evaluate the profile of non-urgent patients triaged 'green', as part of a triage trial in the emergency department (ED) of a secondary care hospital in India. The secondary aim was to validate the triage trial with the South African Triage Score (SATS).
Prospective cohort study.
A secondary care hospital in Mumbai, India.
Patients aged 18 years and above with a history of trauma defined as having any of the external causes of morbidity and mortality listed in block V01-Y36, chapter XX of the International Classification of Disease version 10 codebook, triaged green between July 2016 and November 2019.
Outcome measures were mortality within 24 hours, 30 days and mistriage.
We included 4135 trauma patients triaged green. The mean age of patients was 32.8 (±13.1) years, and 77% were males. The median (IQR) length of stay of admitted patients was 3 (13) days. Half the patients had a mild Injury Severity Score (3-8), with the majority of injuries being blunt (98%). Of the patients triaged green by clinicians, three-quarters (74%) were undertriaged on validating with SATS. On telephonic follow-up, two patients were reported dead whereas one died while admitted in hospital.
Our study highlights the need for implementation and evaluation of training in trauma triage systems that use physiological parameters, including pulse, systolic blood pressure and Glasgow Coma Scale, for the in-hospital first responders in the EDs.
评估在印度一家二级保健医院急诊科进行分诊试验中被分类为“绿色”的非紧急患者的情况。次要目的是使用南非分诊评分（SATS）验证分诊试验。
前瞻性队列研究。
印度孟买的一家二级保健医院。
18 岁及以上有创伤史的患者，创伤定义为国际疾病分类第 10 版代码本第 XX 章 V01-Y36 章节中列出的任何一种发病率和死亡率的外部原因。2016 年 7 月至 2019 年 11 月期间被分诊为绿色。
结果测量是 24 小时、30 天内死亡率和分诊错误。
我们纳入了 4135 例被分诊为绿色的创伤患者。患者的平均年龄为 32.8（±13.1）岁，77%为男性。住院患者的中位（IQR）住院时间为 3（13）天。半数患者的损伤严重程度评分（ISS）为 3-8，大多数损伤为钝性（98%）。在使用 SATS 验证时，被临床医生分诊为绿色的患者中有四分之三（74%）被低估。通过电话随访，有 2 名患者报告死亡，而有 1 名患者在住院期间死亡。
我们的研究强调了需要实施和评估使用生理参数（包括脉搏、收缩压和格拉斯哥昏迷评分）的创伤分诊系统的培训，以便为急诊科的院内急救人员提供培训。
