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Trauma triage: a nine-year experience.

B O'Rourke1, R H Bade, T Drezner

  • 1Emergency Medical Services Agency, County of Orange, California.

Annals of Emergency Medicine
|June 1, 1992
PubMed
Summary

The number of trauma patients significantly increased, suggesting overtriage, with trends changing in 1986 after Injury Severity Score revisions, not the 1983 triage criteria updates.

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Area of Science:

  • Emergency Medicine
  • Trauma Surgery
  • Public Health Policy

Background:

  • The Orange County trauma system experienced significant growth in patient volume between 1980 and 1989.
  • Understanding triage patterns is crucial for effective trauma care resource allocation.

Purpose of the Study:

  • To analyze nine-year trends in trauma patient triage in Orange County.
  • To evaluate the impact of revised triage criteria implemented in July 1983 on patient patterns.

Main Methods:

  • Retrospective analysis of trauma patient triage data from July 1980 to June 1989.
  • Comparison of pre- and post-revision triage patterns.
  • Logarithmic regression analysis and examination of injury severity indicators.

Main Results:

  • A 386% increase in trauma patients triaged to trauma centers was observed.
  • Increases in more severely injured patients (based on Injury Severity Score, hospital stay, fatality, and surgery) outpaced population growth.
  • Overtriage rates for motor vehicle accident patients rose significantly from 43% to 74% between 1981 and 1988.

Conclusions:

  • The trauma patient population growth rate surpassed overall county population growth, indicating potential overtriage.
  • No significant trend changes were detected immediately following the 1983 triage criteria revisions.
  • Observed shifts in trends in 1986 were associated with revisions in the Injury Severity Score scoring system.

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