title: Using crash scene variables to predict the need for trauma center care in older persons.
abstract: Current trauma triage protocols lack sensitivity to occult injuries in older persons, resulting in unacceptable undertriage rates. We identified crash scene information that could be used by emergency personnel to identify the need for trauma center care in older persons injured in motor vehicle crashes. Crash records of 7,883 persons 65 years and older were explored using classification and regression trees (CART) analysis. CART analysis of 26 crash scene variables resulted in two classification trees from which triage decision rules were stated for persons with severe and moderate injuries. Sensitivity and specificity of the rules were 95.15% and 76.47% for severe injury and 83.1% and 81.5% for moderate injury.
authors.affiliation: College of Nursing, Rutgers, The State University of New Jersey, Newark, NJ, USA.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Scheetz
authors.forename: Juan
authors.initials: J
authors.lastname: Zhang
authors.forename: John E
authors.initials: JE
authors.lastname: Kolassa
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000368:Aged / Q000706:statistics & numerical data*; D001696:Biomechanical Phenomena; D003663:Decision Trees; D015577:Geriatric Assessment; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D009104:Multiple Trauma / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology / Q000451:nursing; D020380:Needs Assessment / Q000458:organization & administration*; D009730:Nursing Assessment / Q000458:organization & administration; D015403:Nursing Evaluation Research; D011237:Predictive Value of Tests; D011594:Psychometrics; D012044:Regression Analysis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014193:Trauma Centers; D015599:Trauma Severity Indices; D014218:Triage; D014481:United States / Q000453:epidemiology