title: Mechanism of injury is not a predictor of trauma center admission.
abstract: Most trauma systems use mechanism of injury (MOI) as an indicator for trauma center transport, often overburdening the system as a result of significant overtriage. Before 2005 our trauma center accepted all MOI. After 2005 we accepted only those patients meeting anatomic and physiologic (A&P) triage criteria. Patients entered into the trauma center database were divided into two groups: 2001 to 2005 (Group 1) and 2007 to 2010 (Group 2) and also categorized based on trauma team activation for either A&P or MOI criteria. Overtriage was defined as patient discharge from the emergency department within 6 hours of trauma activation. A total of 9899 patients were reviewed. Group 1 had 6584 patients with 3613 (55%) activated for A&P criteria and 2971 (45%) for MOI. Group 2 had 3315 patients with 3149 (95%) activated for A&P criteria and 166 (5%) for MOI. Accepting only those patients meeting A&P criteria resulted in a decrease in the overtriage rate from 66 to 9 per cent. By accepting only those patients meeting A&P criteria, we significantly reduced our overtriage rate. Patients meeting MOI criteria were transported to community hospitals and transferred to the trauma center if major injuries were identified. Trauma center transport for MOI results in significant overtriage and may not be justified.
authors.affiliation: Department of Surgery, Louisiana State University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Lance E
authors.initials: LE
authors.lastname: Stuke
authors.forename: Juan C
authors.initials: JC
authors.lastname: Duchesne
authors.forename: John P
authors.initials: JP
authors.lastname: Hunt
authors.forename: Alan B
authors.initials: AB
authors.lastname: Marr
authors.forename: Peter C
authors.initials: PC
authors.lastname: Meade
authors.forename: Norman E
authors.initials: NE
authors.lastname: McSwain
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D003663:Decision Trees; D005260:Female; D015600:Glasgow Coma Scale; D006760:Hospitalization; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D012189:Retrospective Studies; D014193:Trauma Centers; D014218:Triage / Q000458:organization & administration*; D014947:Wounds and Injuries / Q000209:etiology* / Q000401:mortality / Q000628:therapy