French Pre-hospital Trauma Triage Criteria: Does the "pre-hospital Resuscitation" Criterion Provide Additional Benefit in Triage?

Overview

Journal World J Crit Care Med

Publisher Baishideng Publishing Group

Specialty Critical Care

Date 2014 Nov 8

PMID 25379459

Citations 3

Authors

Emmanuel Hornez

Olga Maurin

Aurelie Mayet

Tristan Monchal

Federico Gonzalez

Delphine Kerebel

Affiliations

Soon will be listed here.

Abstract

Aim: To evaluate the performance of the specific French Vittel "Pre-Hospital (PH) resuscitation" criteria in selecting polytrauma patients during the pre-hospital stage and its potential to increase the positive predictive value (PPV) of pre-hospital trauma triage.

Methods: This was a monocentric prospective cohort study of injured adults transported by emergency medical service to a trauma center. Patients who met any of the field trauma triage criteria were considered "triage positive". Hospital data was statistically linked to pre-hospital records. The primary outcome of defining a "major trauma patient" was Injury Severity Score (ISS) > 16.

Results: There were a total of 200 injured patients evaluated over a 2 years period who met at least 1 triage criterion. The number of false positives was 64 patients (ISS < 16). The PPV was 68%. The sensitivity and the negative predictive value could not be evaluated in this study since it only included patients with positive Vittel criteria. The criterion of "PH resuscitation" was present for 64 patients (32%), but 10 of them had an ISS < 16. This was statistically significant in correlation with the severity of the trauma in univariate analysis (OR = 7.2; P = 0.005; 95%CI: 1.6-31.6). However, despite this correlation the overall PPV was not significantly increased by the use of the criterion "PH resuscitation" (68% vs 67.8%).

Conclusion: The criterion of "pre-hospital resuscitation" was statistically significant with the severity of the trauma, but did not increase the PPV. The use of "pre-hospital resuscitation" criterion could be re-considered if these results are confirmed by larger studies.

Citing Articles

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