1997 · 106 citations · 18 references
Trauma triage effectiveness can be enhanced by integrating physiological scoring with mechanism of injury criteria. This study tests whether a combined PHI/MOI score improves sensitivity and specificity compared to each score alone. In a prospective analysis of 3,147 adult injury patients, field PHI and MOI scores were calculated and compared to the Injury Severity Score, with ISS ≥ 16 defining major trauma. The combined PHI/MOI score achieved 78 % sensitivity (vs 41 % for PHI and 73 % for MOI) with similar specificity, a statistically significant improvement (p < 0.001), yet still failed to identify all major trauma cases.
Background The objective of this study was to combine a physiologic triage score (prehospital index, PHI) with criteria regarding mechanism of injury (MOI) to increase the efficacy of trauma triage. The specific question being asked was: will the combined score improve the sensitivity and specificity over that of the individual scores? Methods In this prospective study, 3,147 injury patients (all adults >or=to 14 years) were reviewed. Each patient received a PHI score and a MOI score in the field, which were compared with their Injury Severity Score (ISS) at separation. An ISS >or=to 16 was defined as major trauma. Results PHI alone had a sensitivity of 41%, MOI alone had a sensitivity of 73%, whereas the combined PHI/MOI score had a sensitivity of 78%. All three had similar specificities. These findings were statistically significant (p <or=to 0.001). Conclusion The combined PHI/MOI score was better at identifying those patients with ISS scores >or=to 16 compared with the PHI and MOI scores alone. Although this permitted superior triage (and minimized overtriage), the combined score did not identify all major trauma patients.
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Susan P. Baker, Brian O’Neill, William F. Haddon et al. · The Journal of Trauma: Injury, Infection, and Critical Care · 1974 · 7.2K citations
John G. West · Archives of Surgery · 1979 · 549 citations