Evaluation of a Consensus-Based Criterion Standard Definition of Trauma Center Need for Use in Field Triage Research

Brian D. Willenbring, E. Brooke Lerner, Karen Brasel, Jeremy T. Cushman, Clare E. Guse, Manish N. Shah, Robert Swor

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Research on field triage of injured patients is limited by the lack of a widely used criterion standard for defining trauma center need. Injury Severity Score (ISS) >15 has been a commonly used outcome measure in research for determining trauma center need that has never been validated. A multidisciplinary team recently published a consensus-based criterion standard definition of trauma center need, but this measure has not yet been validated. The objective was to determine if the consensus-based criterion standard can be obtained by medical record review and compare patients identified as needing a trauma center by the consensus-based criterion standard vs. ISS >15. A subanalysis of data collected during a 2-year prospective cohort study of 4,528 adult trauma patients transported by EMS to a single trauma center was conducted. These data included ICD-9-CM codes, treatment times, and other patient care data. Presence of the consensus-based criterion standard was determined for each patient. ISS was calculated based on ICD-9-CM codes assigned for billing. The consensus-based criterion standard could be applied to 4,471 (98.7%) cases. ISS could be determined for 4,506 (99.5%) cases. Based on an ISS >15, 8.9% of cases were identified as needing a trauma center. Of those, only 48.2% met the consensus-based criterion standard. Almost all patients that did not meet the consensus-based criterion standard, but had an ISS >15 were diagnosed with chest (rib fractures (100/205 cases)/pneumothorax (57/205 cases), closed head (without surgical intervention 88/205 cases), vertebral (without spinal cord injury 45/205 cases), and/or extremity injuries (39/205 cases). There were 4,053 cases with an ISS

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalPrehospital Emergency Care
Volume20
Issue number1
DOIs
StatePublished - Jan 2 2016

Fingerprint

Triage
Trauma Centers
Injury Severity Score
Research
International Classification of Diseases
Rib Fractures
Wounds and Injuries
Pneumothorax
Spinal Cord Injuries
Medical Records
Patient Care
Cohort Studies
Thorax
Extremities
Head
Outcome Assessment (Health Care)
Prospective Studies

Keywords

  • emergency medical services
  • field triage
  • trauma centers
  • wounds and injury

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency

Cite this

Evaluation of a Consensus-Based Criterion Standard Definition of Trauma Center Need for Use in Field Triage Research. / Willenbring, Brian D.; Lerner, E. Brooke; Brasel, Karen; Cushman, Jeremy T.; Guse, Clare E.; Shah, Manish N.; Swor, Robert.

In: Prehospital Emergency Care, Vol. 20, No. 1, 02.01.2016, p. 1-5.

Research output: Contribution to journalArticle

Willenbring, Brian D. ; Lerner, E. Brooke ; Brasel, Karen ; Cushman, Jeremy T. ; Guse, Clare E. ; Shah, Manish N. ; Swor, Robert. / Evaluation of a Consensus-Based Criterion Standard Definition of Trauma Center Need for Use in Field Triage Research. In: Prehospital Emergency Care. 2016 ; Vol. 20, No. 1. pp. 1-5.
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