title: Limitations of the prehospital index in identifying patients in need of a major trauma center.
abstract: 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.
authors.affiliation: University of Calgary Foothills Hospital, Alberta, Canada.
authors.forename: J R
authors.initials: JR
authors.lastname: Plant
authors.forename: D B
authors.initials: DB
authors.lastname: MacLeod
authors.forename: J
authors.initials: J
authors.lastname: Korbeek
mesh_terms: 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