Applying the trauma triage rule to blunt trauma patients.

A. D. Zechnich, J. R. Hedges, K. Spackman, Jonathan Jui, Richard Mullins

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

OBJECTIVE: To determine the accuracy of the Baxt Trauma Triage Rule (TTR: systolic blood pressure <85 mm Hg; Glasgow Coma Scale-motor score <5; or penetrating trauma to head, neck, or trunk) for prediction of major trauma in an independent data set of blunt trauma patients. METHODS: Retrospective evaluation of the TTR in a cohort of patients identified by Oregon Trauma System entry criteria. Accuracy for prediction of "major trauma" victims was measured using resource-based definitions of major trauma. Participants included 626 adult, blunt trauma patients at a level-I trauma center serving a metropolitan center of more than one million people. RESULTS: Of 524 patients with sufficient registry data to apply the TTR, 95 (18%) and 63 (12%) patients met the criteria for major trauma suggested by Baxt et al. and Emerman et al., respectively. Using the Baxt definition of major trauma, the TTR had a sensitivity of 74% (95% CI: 0.65-0.83) and a specificity of 84% (95% CI: 0.81-0.88). There were 25 significant false-negative results, including 12 patients requiring urgent laparotomy and four patients requiring emergency airway procedures. Using the Emerman definition of major trauma, sensitivity improved modestly to 76% (95% CI: 0.65-0.87) and specificity decreased slightly to 80% (95% CI: 0.77-0.84). CONCLUSIONS: In this blunt trauma population, the Baxt TTR failed to identify a significant number of severely injured patients. Slight alterations in the definition of "major trauma" can significantly affect the performance characteristics of triage instruments.

Original languageEnglish (US)
Pages (from-to)1043-1052
Number of pages10
JournalAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine
Volume2
Issue number12
StatePublished - Dec 1995

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Triage
Wounds and Injuries
Penetrating Head Injuries
Blood Pressure
Glasgow Coma Scale
Trauma Centers
Laparotomy
Registries
Emergencies
Neck

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Applying the trauma triage rule to blunt trauma patients. / Zechnich, A. D.; Hedges, J. R.; Spackman, K.; Jui, Jonathan; Mullins, Richard.

In: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, Vol. 2, No. 12, 12.1995, p. 1043-1052.

Research output: Contribution to journalArticle

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