[Should high-energy traumas always result in a trauma team call?].
BACKGROUND
This study was performed to evaluate the trauma triage system currently used by the general hospital of Viborg County, Denmark. According to the trauma triage system, an isolated high-energy trauma leads to a trauma team call. The aim of the study was to determine whether a high-energy trauma patient with no symptoms of injury is a sufficient indication to lead to a trauma team call.


METHODS
The study was based on prospective registration of traumatised patients admitted to the hospital during the period from 1 March 2000 to 28 February 2003. A ROC curve analysis was used to validate the ability of the trauma points to predict severe injury by isolated high-energy traumas.


RESULTS
The study included 514 trauma patients, 304 of whom had suffered high-energy traumas. The positive predictive value of a trauma team call was 45% of severe injury. Among the subgroup of patients with no immediate symptoms, the positive predictive value was 15%. The ROC curve analysis found the optimum cut point to be a high-energy trauma with at least one symptom of injury. The sensitivity was 70% and the specificity 52%.


CONCLUSIONS
The study suggests that a high-energy trauma patient showing no symptoms of injury is not a sufficient indication to lead to a trauma team call. This has caused a change in the scoring system. A trauma team call based on a high-energy trauma now implies that the patient shows signs of at least one symptom of injury.
Clemmesen
Marie Louise
ML
Sygehus Viborg, Ortopaedkirurgisk Afdeling, Forskningssektionen Karkirurgisk Afsnit og Anaestesiologisk Afdeling. louiseclemmesen@dadlnet.dk
Rytter
Søren
S
Birch
Kathrine
K
Lindholt
Jes S
JS
Jensen
Steffen Skov
SS
Troelsen
Svend
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D012680:Sensitivity and Specificity; D014193:Trauma Centers; D015599:Trauma Severity Indices; D014218:Triage / Q000592:standards*; D000078329:Workforce; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000628:therapy