Outcome assessment of blunt trauma patients who are undertriaged.
BACKGROUND
We investigated the outcomes of injured patients who were undertriaged and compared them with those meeting full trauma team activation (TTA) criteria.


METHODS
Blunt trauma patients (July 2002-January 2008) meeting full TTA criteria and had a partial TTA were in the undertriage group (UTG). Data was collected on demographics, injury severity, OR delays, resource utilization, and outcomes. Excluded: penetrating trauma, transfers, burns, age <18 years.


METHODS
Chi square, P < .05, mean +/- SD.


RESULTS
One thousand four hundred and twenty-four patients with 318 (22.3%) in the UTG and 1,106 in the correctly triaged group (CTG). The CTG was 70.4% male (vs 67.1%; P = .26), 41.5 +/- 19.8 years old (vs 45.8 +/- 20.5; P < .01), and had an injury severity score (ISS) of 24.7 (vs 17.0; P < .0001). The CTG was more likely to require ED intubation (34.9% vs 8.2%; P < .0001), ICU admission (49.0% vs 37.1%; P < .0001), longer ICU/hospital LOS, and more ventilator days (P < .0001) with no differences in OR delays. The UTG had a lower mortality (6.0% vs 16.7%; P < .0001) and were discharged home more often (65.3% vs 52.2%; P = .02).


CONCLUSIONS
The UTG had a lower ISS and improved outcomes compared to the CTG with no differences in OR delays. Despite inherent challenges in TTA protocols, patients who were undertriaged at our institution appear to have satisfactory outcomes.
Cherry
Robert A
RA
Department of Surgery, Shock Trauma Center, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA. rcherry@psu.edu
Bradburn
Eric
E
Nichols
Pamela A
PA
Snavely
Theresa M
TM
Boehmer
Susan Janine
SJ
Mauger
David T
DT
D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010414:Pennsylvania; D012042:Registries; D012189:Retrospective Studies; D014193:Trauma Centers; D014218:Triage; D014949:Wounds, Nonpenetrating / Q000628:therapy*; D055815:Young Adult