A multicenter validation of the prehospital index

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Clinical Triage

Background:

• Trauma severity scoring systems are crucial for efficient patient management.
• The prehospital index (PHI) is a triage-oriented system requiring validation.
• Previous pilot studies indicated favorable performance of the PHI.

Purpose of the Study:

• To prospectively validate the accuracy and reliability of the prehospital index (PHI).
• To assess the PHI's ability to predict critical outcomes in trauma patients.
• To compare PHI performance against existing trauma severity scores.

Main Methods:

• Prospective, multicenter validation involving 3,581 trauma patients across 14 institutions.
• Application of the PHI to assess trauma severity and predict outcomes.
• Generation of predictive curves for PHI against key clinical endpoints.

Main Results:

• The PHI demonstrated high accuracy in predicting the need for emergency life-saving surgery within 4 hours (P < .0001).
• The PHI accurately predicted 72-hour mortality following traumatic injury (P < .0001).
• PHI performance compared favorably with other established triage-oriented trauma scoring systems.

Conclusions:

• The prehospital index (PHI) is a validated and accurate tool for trauma triage.
• PHI effectively predicts critical outcomes, including emergency surgery and mortality.
• This study supports the routine use of PHI in prehospital trauma assessment.