TY  - JOUR
PY  - 2020//
TI  - External signs of trauma: a poor predictor of injury in found down and ground level falls
JO  - American journal of surgery
A1  - Foster, Shannon Marie
A1  - Muller, Alison
A1  - Jones, Pamela
A1  - Engle, Laura
A1  - Sherwood, Alicia
A1  - Geng, Thomas A.
A1  - Ong, Adrian W.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: The significance of external signs (EST) and signs or symptoms of trauma (SS) after ground level falls or found down (GLF/FD) is unclear. We hypothesized that EST and SS were associated with injury.     METHODS: Patients with GLF/FD were retrospectively studied. SS was defined as having any EST, tenderness, or subjective complaint. Outcomes were any significant finding (SF) and Injury Severity Score (ISS) > 8. Diagnostic accuracy of EST and SS were assessed with positive and negative likelihood ratios (LR+, LR-).     RESULTS: Of 578 patients, 66% and 95% had EST and SS respectively. For EST, LR+ and LR-were 1.14 and 0.76 (SF), and 1.21 and 0.64 (ISS>8). For SS, LR+ and LR-were 1.07 and 0.19 (SF), and 1.03 and 0.49 (ISS>8).     CONCLUSION: EST lacked sufficient diagnostic accuracy for SF and ISS>8. Lack of SS was reasonably accurate in ruling out SF but not ISS>8. Triage utilizing EST alone for GLF/FD is not useful.<p />  <p>Language: en</p>
LA  - en
SN  - 0002-9610
UR  - http://dx.doi.org/10.1016/j.amjsurg.2020.06.046
ID  - ref1
ER  -