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Isolated rollover mechanism does not warrant trauma center evaluation
James M Haan1, Erik Glassman, Robbi Hartsock
1R. Adams Cowley Shock Trauma Center University of Maryland, Baltimore, Maryland, USA. james_haan@via-christi.org
The American Surgeon
|November 26, 2009
Summary
Rollover motor vehicle crashes (ROMVC) do not independently predict the need for trauma center care. Most patients involved in ROMVC can be safely treated at non-trauma centers, improving resource allocation.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Public Health
Background:
- Trauma centers expend significant resources assessing patients based on injury mechanism alone.
- Rollover motor vehicle crashes (ROMVC) are a common mechanism of injury often triggering trauma center evaluation.
Purpose of the Study:
- To determine if ROMVC is an independent predictor for trauma center care.
- To evaluate the necessity of trauma center evaluation for ROMVC patients.
Main Methods:
- Retrospective review of patients involved in ROMVC from January 1, 2001, to December 31, 2005.
- Exclusion of patients with confounding factors, focusing on those brought to the trauma center solely for ROMVC.
- Analysis of injury severity, surgical interventions, and intensive care unit admissions.
Main Results:
- Out of 569 ROMVC patients, 65% were discharged with minimal injuries.
- 35% were admitted, with 130 requiring surgery, predominantly for fractures.
- Only 1.1% required immediate surgery for life-threatening conditions; 4.2% needed urgent surgery.
Conclusions:
- Rollover motor vehicle crashes are not an independent predictor for trauma center evaluation or admission.
- The majority of ROMVC patients can be managed at non-trauma centers, optimizing resource utilization.
- Current trauma triage criteria based on ROMVC may be overutilized.
