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Trauma index revisited: a better triage tool
1University Hospital, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033.
Critical Care Medicine
|February 1, 1990
Summary
The Revised Trauma Index (RTI) effectively predicts major trauma and correlates with the Injury Severity Score (ISS). An RTI of 15 or higher offers acceptable undertriage and better overtriage rates than other trauma scales.
Area of Science:
- Emergency Medicine
- Trauma Surgery
- Public Health
Background:
- Triage and bypass protocols are critical in emergency medical services.
- Various scoring systems exist, but their accuracy and efficiency vary.
- The Revised Trauma Index (RTI) is a potential tool for trauma triage.
Purpose of the Study:
- To evaluate the Revised Trauma Index (RTI) for its ability to predict trauma severity.
- To assess the triage accuracy of the RTI in trauma admissions.
- To compare the RTI's performance against established triage criteria.
Main Methods:
- A retrospective analysis of 2,340 trauma admissions was conducted.
- The Revised Trauma Index (RTI) and Injury Severity Score (ISS) were calculated for each patient.
- Statistical analysis compared RTI and ISS data, including undertriage and overtriage rates against other scales.
Main Results:
- A linear correlation (r=.62) was found between the RTI and the ISS.
- An RTI of 15 indicated a 5% death rate, with a 5% undertriage rate for mortality.
- The RTI demonstrated a 37.3% overtriage rate for predicting an ISS > 15, outperforming other scales.
Conclusions:
- The RTI is a simple and rapid tool for predicting major trauma.
- The RTI demonstrates a strong relationship with the Injury Severity Score (ISS).
- An RTI threshold of ≥15 provides acceptable undertriage and superior overtriage rates, supporting its use in emergency protocols.