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Accuracy and influencing factors of the Field Triage Decision Scheme for adult trauma patients at a level-1 trauma center in Korea
BACKGROUND: We evaluated the accuracy of the prehospital Field Triage Decision Scheme, which has recently been applied in the Korean trauma system, and the factors associated with severe injury and prognosis at a regional trauma center in Korea. METHODS: From 2016 to 2018, prehospital data of injure...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9172086/ https://www.ncbi.nlm.nih.gov/pubmed/35672707 http://dx.doi.org/10.1186/s12873-022-00637-1 |
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author | Kang, Byung Hee Jung, Kyoungwon Kim, Sora Youn, So Hyun Song, Seo Young Huh, Yo Chang, Hyuk-Jae |
author_facet | Kang, Byung Hee Jung, Kyoungwon Kim, Sora Youn, So Hyun Song, Seo Young Huh, Yo Chang, Hyuk-Jae |
author_sort | Kang, Byung Hee |
collection | PubMed |
description | BACKGROUND: We evaluated the accuracy of the prehospital Field Triage Decision Scheme, which has recently been applied in the Korean trauma system, and the factors associated with severe injury and prognosis at a regional trauma center in Korea. METHODS: From 2016 to 2018, prehospital data of injured patients were obtained from the emergency medical services of the national fire agency and matched with trauma outcomes at our institution. Severe injury (Injury Severity Score > 15), overtriage/undertriage rate, positive predictive value, negative predictive value, and accuracy were reviewed according to the triage protocol steps. A multivariate logistic regression analysis was performed to identify influencing factors in the field triage. RESULTS: Of the 2438 patients reviewed, 853 (35.0%) were severely injured. The protocol accuracy was as follows: step 1, 72.3%; step 2, 65.0%; step 3, 66.2%; step 1 or 2, 70.2%; and step 1, 2, or 3, 66.4%. Odds ratios (OR) (95% confidence interval [CIfor systolic blood pressure < 90 mmHg (3.535 [1.920–6.509]; p < 0.001), altered mental status (17.924 [8.980–35.777]; p < 0.001), and pedestrian injuries (2.473 [1.339–4.570], p = 0.04) were significantly associated with 24-h mortality. Penetrating torso injuries (7.108 [4.108–12.300]; p < 0.001); two or more proximal long bone fractures (4.134 [2.316–7.377]); p < 0.001); crushed, degloved, and mangled extremities (8.477 [4.068–17.663]; p < 0.001); amputation proximal to the wrist or ankle (42.964 [5.764–320.278]; p < 0.001); and fall from height (2.141 [1.497–3.062]; p < 0.001) were associated with 24-h surgical intervention. CONCLUSION: The Korean field triage protocol is not yet accurate, with only some factors reflecting injury severity, making reevaluation necessary. |
format | Online Article Text |
id | pubmed-9172086 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-91720862022-06-08 Accuracy and influencing factors of the Field Triage Decision Scheme for adult trauma patients at a level-1 trauma center in Korea Kang, Byung Hee Jung, Kyoungwon Kim, Sora Youn, So Hyun Song, Seo Young Huh, Yo Chang, Hyuk-Jae BMC Emerg Med Research BACKGROUND: We evaluated the accuracy of the prehospital Field Triage Decision Scheme, which has recently been applied in the Korean trauma system, and the factors associated with severe injury and prognosis at a regional trauma center in Korea. METHODS: From 2016 to 2018, prehospital data of injured patients were obtained from the emergency medical services of the national fire agency and matched with trauma outcomes at our institution. Severe injury (Injury Severity Score > 15), overtriage/undertriage rate, positive predictive value, negative predictive value, and accuracy were reviewed according to the triage protocol steps. A multivariate logistic regression analysis was performed to identify influencing factors in the field triage. RESULTS: Of the 2438 patients reviewed, 853 (35.0%) were severely injured. The protocol accuracy was as follows: step 1, 72.3%; step 2, 65.0%; step 3, 66.2%; step 1 or 2, 70.2%; and step 1, 2, or 3, 66.4%. Odds ratios (OR) (95% confidence interval [CIfor systolic blood pressure < 90 mmHg (3.535 [1.920–6.509]; p < 0.001), altered mental status (17.924 [8.980–35.777]; p < 0.001), and pedestrian injuries (2.473 [1.339–4.570], p = 0.04) were significantly associated with 24-h mortality. Penetrating torso injuries (7.108 [4.108–12.300]; p < 0.001); two or more proximal long bone fractures (4.134 [2.316–7.377]); p < 0.001); crushed, degloved, and mangled extremities (8.477 [4.068–17.663]; p < 0.001); amputation proximal to the wrist or ankle (42.964 [5.764–320.278]; p < 0.001); and fall from height (2.141 [1.497–3.062]; p < 0.001) were associated with 24-h surgical intervention. CONCLUSION: The Korean field triage protocol is not yet accurate, with only some factors reflecting injury severity, making reevaluation necessary. BioMed Central 2022-06-07 /pmc/articles/PMC9172086/ /pubmed/35672707 http://dx.doi.org/10.1186/s12873-022-00637-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Kang, Byung Hee Jung, Kyoungwon Kim, Sora Youn, So Hyun Song, Seo Young Huh, Yo Chang, Hyuk-Jae Accuracy and influencing factors of the Field Triage Decision Scheme for adult trauma patients at a level-1 trauma center in Korea |
title | Accuracy and influencing factors of the Field Triage Decision Scheme for adult trauma patients at a level-1 trauma center in Korea |
title_full | Accuracy and influencing factors of the Field Triage Decision Scheme for adult trauma patients at a level-1 trauma center in Korea |
title_fullStr | Accuracy and influencing factors of the Field Triage Decision Scheme for adult trauma patients at a level-1 trauma center in Korea |
title_full_unstemmed | Accuracy and influencing factors of the Field Triage Decision Scheme for adult trauma patients at a level-1 trauma center in Korea |
title_short | Accuracy and influencing factors of the Field Triage Decision Scheme for adult trauma patients at a level-1 trauma center in Korea |
title_sort | accuracy and influencing factors of the field triage decision scheme for adult trauma patients at a level-1 trauma center in korea |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9172086/ https://www.ncbi.nlm.nih.gov/pubmed/35672707 http://dx.doi.org/10.1186/s12873-022-00637-1 |
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