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Predictive performance of prehospital trauma triage tools for resuscitative interventions within 24 hours in high-risk or life-threatening prehospital trauma patients.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968543 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-227X (Electronic) Linking ISSN: 1471227X NLM ISO Abbreviation: BMC Emerg Med Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Triage*/methods ; Triage*/standards ; Emergency Medical Services*/methods ; Wounds and Injuries*/therapy ; Wounds and Injuries*/diagnosis ; Resuscitation*/methods; Humans ; Retrospective Studies ; Male ; Female ; Adult ; Middle Aged ; Glasgow Coma Scale ; ROC Curve ; Predictive Value of Tests ; Aged ; Young Adult ; Risk Assessment ; Adolescent ; Early Warning Score ; Time Factors
    • Abstract:
      Introduction: Several prehospital trauma triage tools have been recently developed, but no standardized tools currently exist to identify trauma patients at risk of requiring resuscitative interventions (RIs) within the first 24 h post-injury and to prioritize their transport to high-level trauma facilities.
      Methods: This prognostic study employed a retrospective cohort design to evaluate the predictive performance of the Triage Revised Score (T-RTS), Glasgow Coma Scale, Age, and Systolic Blood Pressure Score (GAP), Mechanism, Glasgow Coma Scale, Age, and Systolic Blood Pressure Score (MGAP), National Early Warning Score 2 (NEWS-2), Shock Index (SI), and Reverse Shock Index multiplied by Glasgow Coma Scale (rSIG) in predicting the need for RIs within 24 h. Data was retrieved from the electronic medical records of Ramathibodi Hospital, and the study included patients aged ≥ 15 years who were categorized as high-risk or life-threatening and subsequently transported to the emergency department. We used Area Under the Receiver Operating Characteristic (AUROC) curve and calibration plots to assess the performance of prehospital trauma triage tools.
      Results: There were 440 traumatic injury patients enrolled in the study, with 44 (10%) receiving RIs. T-RTS, GAP, MGAP, and NEWS-2 demonstrate good discriminative and predictive performance for RIs within 24 h after an injury (AUROC of 0.969, 0.949, 0.971, and 0.929, respectively, with the O:E ratio of 1). With the predefined standard cut-off values, the GAP score of less than 19 results in the highest accuracy for ruling out patients who do not need RIs (Specificity = 94.4% and NPV = 94.1%, p-value < 0.001).
      Conclusions: Several commonly used prehospital trauma triage tools demonstrate good predictive abilities for identifying the need for RIs. Among these, the GAP score with a threshold value of 19 serves as an optimal tool for identifying patients who require transfer to high-level trauma facilities.
      (© 2025. The Author(s).)
    • Abstract:
      Declarations. Ethics approval and consent to participate: The study fully complies with International Human Research Protection Guidelines such as the Declaration of Helsinki and the Belmont Report. This study was approved by the Faculty of Medicine, Committee on Human Rights Related to Research Involving Human Subjects, Ramathibodi Hospital, Mahidol University (COA. NO MURA2023/170). As the study is a retrospective observational study, the consent for participation was waived by the Institutional Review Boards. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
    • References:
      BMC Emerg Med. 2024 Sep 9;24(1):163. (PMID: 39251893)
      Resuscitation. 2015 Apr;89:31-5. (PMID: 25583148)
      Cir Esp. 2015 Apr;93(4):213-21. (PMID: 25015031)
      BMC Emerg Med. 2022 May 28;22(1):90. (PMID: 35643425)
      Injury. 2020 Jul;51(7):1554-1560. (PMID: 32430198)
      Emerg Med J. 2017 Aug;34(8):533-537. (PMID: 28501815)
      Crit Care. 2018 Apr 11;22(1):87. (PMID: 29642920)
      J Trauma. 1989 May;29(5):623-9. (PMID: 2657085)
      MMWR Recomm Rep. 2012 Jan 13;61(RR-1):1-20. (PMID: 22237112)
      Crit Care Med. 2010 Mar;38(3):831-7. (PMID: 20068467)
      J Trauma Acute Care Surg. 2017 Aug;83(2):328-339. (PMID: 28452898)
      J Trauma Acute Care Surg. 2021 Jun 1;90(6):e138-e145. (PMID: 33605709)
      Lancet. 2020 Oct 17;396(10258):1204-1222. (PMID: 33069326)
      Int J Environ Res Public Health. 2022 Dec 08;19(24):. (PMID: 36554366)
      Stat Med. 2006 Feb 28;25(4):559-73. (PMID: 16217835)
      World J Emerg Surg. 2021 Jun 10;16(1):31. (PMID: 34112209)
      JAMA Netw Open. 2022 Jan 4;5(1):e2145860. (PMID: 35099548)
      Stat Med. 2021 Aug 30;40(19):4230-4251. (PMID: 34031906)
      Injury. 2024 May;55(5):111267. (PMID: 38129233)
      Crit Care. 2011 Aug 10;15(4):R191. (PMID: 21831280)
      Prehosp Emerg Care. 2019 Jul-Aug;23(4):543-550. (PMID: 30457396)
      Int J Environ Res Public Health. 2018 Oct 24;15(11):. (PMID: 30355971)
      PLoS One. 2022 Mar 17;17(3):e0265559. (PMID: 35298560)
      Prehosp Disaster Med. 2019 Dec;34(6):610-618. (PMID: 31648657)
      Prehosp Emerg Care. 2015 Apr-Jun;19(2):267-71. (PMID: 25290529)
      J Trauma. 2009 Dec;67(6):1426-30. (PMID: 20009697)
      Open Access Emerg Med. 2023 Mar 21;15:79-91. (PMID: 36974278)
    • Contributed Indexing:
      Keywords: Intervention; Resuscitation; Trauma triage tool; Traumatic injury; Triage
    • Publication Date:
      Date Created: 20250220 Date Completed: 20250508 Latest Revision: 20250508
    • Publication Date:
      20260130
    • Accession Number:
      PMC11841352
    • Accession Number:
      10.1186/s12873-025-01188-x
    • Accession Number:
      39979975