TY  - JOUR
PY  - 2014//
TI  - A critical analysis of secondary overtriage to a Level I trauma center
JO  - Journal of trauma and acute care surgery
A1  - Tang, Andrew
A1  - Hashmi, Ammar
A1  - Pandit, Viraj
A1  - Joseph, Bellal
A1  - Kulvatunyou, Narong
A1  - Vercruysse, Gary
A1  - Zangbar, Bardiya
A1  - Gries, Lynn
A1  - O'Keeffe, Terence
A1  - Green, Donald
A1  - Friese, Randall
A1  - Rhee, Peter
SP  - 969
EP  - 973
VL  - 77
IS  - 6
N2  - BACKGROUND: Trauma centers often receive transfers from lower-level trauma centers or nontrauma hospitals. The aim of this study was to analyze the incidence and pattern of secondary overtriage to our Level I trauma center. <br><br>METHODS: We performed a 2-year retrospective analysis of all trauma patients transferred to our Level I trauma center and discharged within 24 hours of admission. Reason for referral, referring specialty, mode of transport, and intervention details were collected. Outcomes measures were incidence of secondary overtriage as well as requirement of major or minor procedure. Major procedure was defined as surgical intervention in the operating room. Minor procedures were defined as procedures performed in the emergency department. <br><br>RESULTS: A total of 1,846 patients were transferred to our Level I trauma center, of whom 440 (24%) were discharged within 24 hours of admission. The mean (SD) age was 35 (21) years, 72% were male, and mean (SD) Injury Severity Score (ISS) 4 (4). The most common reasons for referral were extremity fractures (31%), followed by head injury (23%) and soft tissue injuries (13%).Of the 440 patients discharged within 24 hours, 380 (86%) required only observation (268 of 380) or minor procedure (112 of 380). Minor procedures were entirely consisted of fracture management (n = 47, 42%) and wound care (n = 65, 58%). The mean (SD) interfacility transfer distance was 45 (46) miles. Mean (SD) hospital charges per transfer were $12,549 ($5,863). <br><br>CONCLUSION: A significant number of patients transferred to our trauma center were discharged within 24 hours; most of them required observation and/or minor procedures. Appropriately increasing primary hospital resources, in addition to interhospital outreach in the form of education or telemedicine, should be considered to decrease the number of avoidable transfers. LEVEL OF EVIDENCE: Epidemiologic study, level III.<p />  <p>Language: en</p>
LA  - en
SN  - 2163-0755
UR  - http://dx.doi.org/10.1097/TA.0000000000000462
ID  - ref1
ER  -