Limitations of the prehospital index in identifying patients in need of a major trauma center.
OBJECTIVE
To evaluate the usefulness of the prehospital index (PHI) as a triage tool in a population of trauma patients.


METHODS
Retrospective analysis.


METHODS
The two adult trauma centers in Calgary, Alberta, Canada, serving a population of 1.2 million.


METHODS
Six hundred forty-four consecutive patients admitted during an 18-month period with injury severity scores (ISSs) of 16 or more.


RESULTS
PHI of 4 or more was statistically related to death within 72 hours of emergency department presentation (P < .00001), emergency surgery within 24 hours (P < .039), emergency surgery within 4 hours (P < .00001), and emergency surgery within 4 hours or death within 72 hours (P < .0001). A more important statistic, however, in the evaluation of a screening tool is sensitivity. PHI of 4 or more had a sensitivity of 98% in identifying mortality but had sensitivity of only 59% for emergency surgery within 24 hours and 71% for emergency surgery within 4 hours.


CONCLUSIONS
PHI of 4 or more had limitations as a screening tool for triage in our study population because of the high number of patients it categorized as having minor trauma who required emergency surgery.
Plant
J R
JR
University of Calgary Foothills Hospital, Alberta, Canada.
MacLeod
D B
DB
Korbeek
J
J
D000416:Alberta; D006801:Humans; D015601:Injury Severity Score; D008499:Medical Records; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D014193:Trauma Centers; D014218:Triage; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery