Secondary Undertriage in a Rural Trauma System: A Retrospective Study of Twice-Transferred Patients

Area of Science:

• Trauma surgery
• Emergency medicine
• Public health systems

Background:

• Undertriage is a key metric for trauma system efficiency, particularly in rural settings where long distances necessitate initial undertriage.
• This study examines secondary trauma triaging in a rural context by analyzing data from multiple transferred trauma patients.

Purpose of the Study:

• To investigate trends in secondary undertriage within a rural trauma system.
• To compare current undertriage rates with historical data from 1996-1999.

Main Methods:

• Retrospective cohort study of 100 trauma patients transferred multiple times between 2017 and 2020.
• Data collected from institutional trauma registry and medical records.
• Comparison with a previous study cohort from 1996-1999.

Main Results:

• 87 patients were included: 70 adults and 17 pediatric.
• The rate of twice-transferred trauma patients significantly decreased from 3.0% in 1996-1999 to 0.66% (P < 0.05) between 2017-2020.
• Patients were older and less likely to be male compared to the earlier study cohort.

Conclusions:

• The rate of secondary undertriage, defined by multiple patient transfers, has significantly declined over the past two decades in this rural state.
• Further research is needed to determine the impact of multiple transfers on patient outcomes.