J Med Life Sci > Volume 17(1); 2020 > Article
Journal of Medicine and Life Science 2020;17(1):7-15.
DOI: https://doi.org/10.22730/jmls.2020.17.1.7    Published online April 30, 2020.
Validation of Guidelines for Field Triage of Injured Patients for major trauma in patients of brain and spinal injury.
Sung Kgun Lee, Jeong Ho Kang, Sung Wook Song
Jeju National University
Correspondence:  Jeong Ho Kang, Email: sivakjh1234@gmail.com
The field triage guidelines have been widely implemented in the Korean trauma system. This study aimed to evaluate and validate whether it is reliable to use the field triage guidelines for predicting severe traumatic brain injury (TBI) and traumatic spinal injury (TSI) patients. Study design: This study retrospectively analyzed in-hospital cohort registries of all TBI and TSI patients, who visited the emergency department (ED) of the Jeju National University Hospital from 1 January 2013 to 31 December 2015. The primary outcome was defined as TBI and TSI patients with an injury severity score (ISS) > 15. Secondary outcomes were defined as cases in which one or more of the following conditions: in-hospital death, ISS > 15, admission to the intensive care unit, emergency surgery.
We enrolled 14,889 TBI and TSI patients who visited ED, of which 7,966 (53.5%) were triage positive. The overall sensitivity, specificity and area under the curve (AUC) of the full cumulative field triage guidelines step’s model (Step 1+3+4 criteria) for primary outcome were 82.8% and 47.0% and 0.646 respectively. In the results for secondary outcomes, the specificity did not show a significant difference, but the sensitivity decreased to 66.5% and AUC to 0.568.
The results of this study suggest that further optimization of the field triage guidelines is needed to identify high-risk TBI and TSI patients.
Key Words: triage, traumatic, brain, injury, spinal, injuries, criteria
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