Trauma triage criteria as predictors of severe injury - a Swedish multicenter cohort study
Dublin Core
Title
Trauma triage criteria as predictors of severe injury - a Swedish multicenter cohort study
Subject
Trauma triage criteria, Sensitivity, Specifcity, Accuracy, Undertriage
Description
Background: Adequate performance of trauma team activation (TTA) criteria is important in order to accurately
triage trauma patients. The Swedish National Trauma Triage Criteria (SNTTC) consists of 29 criteria that trigger either a
Trauma Alert, the highest level of TTA, or a Trauma Response. This study aimed to evaluate the SNTTC and its accuracy
in predicting a severely injured patient in a multicenter setting.
Methods: A cohort study in Sweden involving six trauma receiving hospitals. Data was collected from the Swedish
Trauma Registry. Some 626 patients were analyzed with regard to the specifc criteria used to initiate the TTA, injury
severity with New Injury Severity Score (NISS) and emergency interventions. Sensitivity, specifcity, positive predictive
value (PPV) and positive likelihood ratio (LR+) of the criteria were calculated, as well as undertriage and overtriage.
Results: All 29 criteria of SNTTC had a sensitivity >80% for identifying a severely injured patient. The 16 Trauma Alert
Criteria had a lower sensitivity of 62.6% but higher LR+ (3.5 vs all criteria 1.4), specifcity (82.3 vs 39.1%) and PPV (55.4
vs 37.6%) and the highest accuracy (AUC 0.724). When using only the six physiological criteria, sensitivity (44.8%) and
accuracy (AUC 0.690) decreased while LR+ (6.7), specifcity (93.3%) and PPV (70.2%) improved.
Conclusion: SNTTC is efcient in identifying severely injured patients. The current set of criteria exhibits the best
sensitivity compared to other examined combinations and no additional criterion was found to improve the protocol
enough to promote a change.
triage trauma patients. The Swedish National Trauma Triage Criteria (SNTTC) consists of 29 criteria that trigger either a
Trauma Alert, the highest level of TTA, or a Trauma Response. This study aimed to evaluate the SNTTC and its accuracy
in predicting a severely injured patient in a multicenter setting.
Methods: A cohort study in Sweden involving six trauma receiving hospitals. Data was collected from the Swedish
Trauma Registry. Some 626 patients were analyzed with regard to the specifc criteria used to initiate the TTA, injury
severity with New Injury Severity Score (NISS) and emergency interventions. Sensitivity, specifcity, positive predictive
value (PPV) and positive likelihood ratio (LR+) of the criteria were calculated, as well as undertriage and overtriage.
Results: All 29 criteria of SNTTC had a sensitivity >80% for identifying a severely injured patient. The 16 Trauma Alert
Criteria had a lower sensitivity of 62.6% but higher LR+ (3.5 vs all criteria 1.4), specifcity (82.3 vs 39.1%) and PPV (55.4
vs 37.6%) and the highest accuracy (AUC 0.724). When using only the six physiological criteria, sensitivity (44.8%) and
accuracy (AUC 0.690) decreased while LR+ (6.7), specifcity (93.3%) and PPV (70.2%) improved.
Conclusion: SNTTC is efcient in identifying severely injured patients. The current set of criteria exhibits the best
sensitivity compared to other examined combinations and no additional criterion was found to improve the protocol
enough to promote a change.
Creator
Lina Holmberg , Kevin Mani , Knut Thorbjørnsen , Anders Wanhainen , Håkan Andréasson , Claes Juhlin and Fredrik Linder
Publisher
BMC Emergency Medicine
Date
(2022) 22:40
Contributor
Fajar bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Lina Holmberg , Kevin Mani , Knut Thorbjørnsen , Anders Wanhainen , Håkan Andréasson , Claes Juhlin and Fredrik Linder, “Trauma triage criteria as predictors of severe injury - a Swedish multicenter cohort study,” Repository Horizon University Indonesia, accessed April 4, 2025, https://repository.horizon.ac.id/items/show/4059.