A regional trauma system to optimize the pre-hospital triage of trauma patients

Pierre Bouzat, François Xavier Ageron, Julien Brun, Albrice Levrat, Marion Berthet, Elisabeth Rancurel, Jean Marc Thouret, Frederic Thony, Catherine Arvieux, Jean François Payen, François Albasini, Frédéric Champly, Vincent Danel, Guillaume Debaty, Fabienne Grailles, Daniel Habold, Christophe Hoareau, Guillaume Peribois, Dominique Savary, Claire Vallenet

Research output: Contribution to journalArticle

Abstract

Introduction: Pre-hospital triage is a key element in a trauma system that aims to admit patients to the most suitable trauma center, and may decrease intra-hospital mortality. We evaluated the performance of a pre-hospital procedure in a regional trauma system through measurements of the quality of pre-hospital medical assessment and the efficacy of a triage protocol. Methods: Our regional trauma system included 13 hospitals categorized as Level I, II or III trauma centers according to their technical facilities. Each patient was graded A, B or C by an emergency physician, according to the seriousness of their injuries at presentation on scene. The triage was performed according to this grading and the categorization of centers. This study is a registry analysis of a three-year period (2009 to 2011). Results: Of the 3,428 studied patients, 2,572 were graded using the pre-hospital grading system (Graded group). The pre-hospital gradation was closely related with injury severity score (ISS) and intra-hospital mortality rate. The triage protocol had a sensitivity of 92% (95% confidence interval (CI) 90% to 93%) and a specificity of 41% (95% CI 39% to 44%) to predict adequate admission of patients with ISS more than 15. A total of 856 patients were not graded at the scene (Non-graded group). Undertriage rate was significantly reduced in the Graded group compared with the Non-graded group, with a relative risk of 0.47 (95% CI 0.40 to 0.56) according to the definition of the American College of Surgeons Committee on Trauma (P

Original languageEnglish (US)
Article number111
JournalCritical Care
Volume19
Issue number1
DOIs
StatePublished - Mar 18 2015
Externally publishedYes

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Triage
Wounds and Injuries
Injury Severity Score
Trauma Centers
Confidence Intervals
Hospital Mortality
Patient Admission
Registries
Emergencies
Physicians
Mortality

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Bouzat, P., Ageron, F. X., Brun, J., Levrat, A., Berthet, M., Rancurel, E., ... Vallenet, C. (2015). A regional trauma system to optimize the pre-hospital triage of trauma patients. Critical Care, 19(1), [111]. https://doi.org/10.1186/s13054-015-0835-7

A regional trauma system to optimize the pre-hospital triage of trauma patients. / Bouzat, Pierre; Ageron, François Xavier; Brun, Julien; Levrat, Albrice; Berthet, Marion; Rancurel, Elisabeth; Thouret, Jean Marc; Thony, Frederic; Arvieux, Catherine; Payen, Jean François; Albasini, François; Champly, Frédéric; Danel, Vincent; Debaty, Guillaume; Grailles, Fabienne; Habold, Daniel; Hoareau, Christophe; Peribois, Guillaume; Savary, Dominique; Vallenet, Claire.

In: Critical Care, Vol. 19, No. 1, 111, 18.03.2015.

Research output: Contribution to journalArticle

Bouzat, P, Ageron, FX, Brun, J, Levrat, A, Berthet, M, Rancurel, E, Thouret, JM, Thony, F, Arvieux, C, Payen, JF, Albasini, F, Champly, F, Danel, V, Debaty, G, Grailles, F, Habold, D, Hoareau, C, Peribois, G, Savary, D & Vallenet, C 2015, 'A regional trauma system to optimize the pre-hospital triage of trauma patients', Critical Care, vol. 19, no. 1, 111. https://doi.org/10.1186/s13054-015-0835-7
Bouzat P, Ageron FX, Brun J, Levrat A, Berthet M, Rancurel E et al. A regional trauma system to optimize the pre-hospital triage of trauma patients. Critical Care. 2015 Mar 18;19(1). 111. https://doi.org/10.1186/s13054-015-0835-7
Bouzat, Pierre ; Ageron, François Xavier ; Brun, Julien ; Levrat, Albrice ; Berthet, Marion ; Rancurel, Elisabeth ; Thouret, Jean Marc ; Thony, Frederic ; Arvieux, Catherine ; Payen, Jean François ; Albasini, François ; Champly, Frédéric ; Danel, Vincent ; Debaty, Guillaume ; Grailles, Fabienne ; Habold, Daniel ; Hoareau, Christophe ; Peribois, Guillaume ; Savary, Dominique ; Vallenet, Claire. / A regional trauma system to optimize the pre-hospital triage of trauma patients. In: Critical Care. 2015 ; Vol. 19, No. 1.
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AU - Berthet, Marion

AU - Rancurel, Elisabeth

AU - Thouret, Jean Marc

AU - Thony, Frederic

AU - Arvieux, Catherine

AU - Payen, Jean François

AU - Albasini, François

AU - Champly, Frédéric

AU - Danel, Vincent

AU - Debaty, Guillaume

AU - Grailles, Fabienne

AU - Habold, Daniel

AU - Hoareau, Christophe

AU - Peribois, Guillaume

AU - Savary, Dominique

AU - Vallenet, Claire

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