Citation

Raux M, Sartorius D, Le Manach Y, David JS, Riou B, Vivien B. J. Trauma 2011; 71(3): 754-759.

Affiliation

From the Departments of Anesthesiology and Critical Care (M.R., Y.L.M.) and Emergency Medicine and Surgery (D.S., B.R.), Centre Hospitalo-Universitaire Pitié-Salpêtrière, Université Pierre et Marie Curie-Paris 6, Paris, France; Service d'Aide Médicale Urgente de Lyon (J.-S.D.), Université Lyon Sud, Lyon, France; Department of Emergency Medicine (J.-S.D.), Centre Hospitalo-Universitaire Lyon Sud, Pierre Bénite, France; Service d'Aide Médicale Urgente de Paris and Department of Anesthesiology and Critical Care (B.V.), Centre Hospitalo-Universitaire Necker-Enfants Malades, Université Paris Descartes-Paris 5, Paris, France.

Copyright

(Copyright © 2011, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0b013e3181fd0dae

PMID

21336194

Abstract

BACKGROUND:: Little information is available concerning the ability of prehospital triage scores to predict endpoints other than mortality. METHODS:: We evaluated two cohorts (a national cohort of 1,360 patients during 2002 and a single center cohort of 1,003 patients in 2003-2005) of trauma patients receiving care from a prehospital mobile intensive care unit (ICU). We tested the ability of prehospital triage scores (MGAP, Revised Trauma Score [RTS], and triage RTS [T-RTS]) to predict a severe injury, the need for a prolonged ICU period, the occurrence of massive hemorrhage, and the need for emergency procedures, and compared them with a reference score (Trauma-Related Injury Severity Score [TRISS]). The areas under the receiver operating characteristic (AUCROC) curves were measured. RESULTS:: The MGAP, RTS, and T-RTS scores were able to predict an Injury Severity Score >15 (AUCROC: 0.75, 0.75, and 0.74, respectively), the need for a stay in ICU >2 days or death (AUCROC of 0.85, 0.83, and 0.83, respectively), and the massive hemorrhage (AUCROC: 0.70, 0.72, and 0.73, respectively). In contrast, MGAP, RTS, T-RTS, and TRISS scores were not predictors of the need of an emergency procedure (AUCROC: 0.53, 0.51, and 0.52, respectively). Four independent predictors of emergency procedure were noted: penetrating trauma, intravenous colloid administration >750 mL, systolic arterial blood pressure <100 mm Hg, and heart rate >100 bpm. CONCLUSION:: Prehospital triage scores were predictors of Injury Severity Score >15, prolonged ICU stay, and massive hemorrhage but not of emergency procedure requirement.

Language: en