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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 2/2022

01-04-2022 | Triage | Original Article

ISS is not an appropriate tool to estimate overtriage

Authors: Paër-sélim Abback, Kelly Brouns, Jean-Denis Moyer, Mathilde Holleville, Camille Hego, Caroline Jeantrelle, Hélène Bout, Isabelle Rennuit, Arnaud Foucrier, Anaïs Codorniu, Igor Jurcisin, Catherine Paugam-Burtz, Tobias Gauss

Published in: European Journal of Trauma and Emergency Surgery | Issue 2/2022

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Abstract

Purpose

The aim of this work is to study a cohort of patients of ISS < 15 admitted to a TC, and to determine the number of patients that ultimately benefited from the skills and resources specific of a level 1 trauma center.

Methods

Retrospective study from a prospective cohort of patients admitted to TC (Beaujon Hospital, APHP) for suspected severe trauma from January 2011 to December 2017. The main outcome criterion was the use of surgery or interventional radiology within the first 24 h after admission of patients with ISS < 15. The secondary outcomes were stratified into severe (mortality, resuscitation care, length of stay in intensive care units) and non-severe criteria (mild head injury, hospital discharge or transfer within 24 h).

Results

Of 3035 patients admitted during the study period, 1409 with an ISS < 15 were included, corresponding to a theoretical overtriage rate of 46.4%. Among these, 611 patients (43.4%) underwent emergency intervention within the first 24 h (586 surgical interventions, 19 direct transfers to the operating theater and 6 acts of interventional radiology), 238 (16.9%) of patients presented with severe and 531 (38%) with non-severe outcome criteria.

Conclusion

This work demonstrates that in a cohort of patients classified as ISS < 15 admitted to a TC, a considerable amount of TC-specific resources are required, and patients present with severe outcome criteria despite being classified as overtriaged. These results suggest that triage of trauma patients should be based on resource use and clinical outcome rather than anatomic criteria.
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Metadata
Title
ISS is not an appropriate tool to estimate overtriage
Authors
Paër-sélim Abback
Kelly Brouns
Jean-Denis Moyer
Mathilde Holleville
Camille Hego
Caroline Jeantrelle
Hélène Bout
Isabelle Rennuit
Arnaud Foucrier
Anaïs Codorniu
Igor Jurcisin
Catherine Paugam-Burtz
Tobias Gauss
Publication date
01-04-2022
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 2/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-021-01637-9

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