title: Field trauma triage: combining mechanism of injury with the prehospital index for an improved trauma triage tool.
abstract: BACKGROUND
  The objective of this study was to combine a physiologic triage score (prehospital index, PHI) with criteria regarding mechanism of injury (MOI) to increase the efficacy of trauma triage. The specific question being asked was: will the combined score improve the sensitivity and specificity over that of the individual scores?
  
  
  METHODS
  In this prospective study, 3,147 injury patients (all adults > or = 14 years) were reviewed. Each patient received a PHI score and a MOI score in the field, which were compared with their Injury Severity Score (ISS) at separation. An ISS > or = 16 was defined as major trauma.
  
  
  RESULTS
  PHI alone had a sensitivity of 41%, MOI alone had a sensitivity of 73%, whereas the combined PHI/MOI score had a sensitivity of 78%. All three had similar specificities. These findings were statistically significant (p < or = 0.001).
  
  
  CONCLUSIONS
  The combined PHI/MOI score was better at identifying those patients with ISS scores > or = 16 compared with the PHI and MOI scores alone. Although this permitted superior triage (and minimized overtriage), the combined score did not identify all major trauma patients.
authors.affiliation: Department of Surgery, University of Calgary, Alberta, Canada.
authors.forename: R J
authors.initials: RJ
authors.lastname: Bond
authors.forename: J B
authors.initials: JB
authors.lastname: Kortbeek
authors.forename: R M
authors.initials: RM
authors.lastname: Preshaw
mesh_terms: D000059:Accidents; D000293:Adolescent; D000328:Adult; D004632:Emergency Medical Services; D006801:Humans; D015601:Injury Severity Score; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013177:Sports; D014218:Triage / Q000379:methods* / Q000592:standards; D014754:Violence; D014947:Wounds and Injuries / Q000145:classification* / Q000175:diagnosis / Q000209:etiology