[Should high-energy traumas always result in a trauma team call?]. / Bør højenergiulykker altid medføre tilkald af traumeteam?

ABSTRACT

BACKGROUND: This study was performed to evaluate the trauma triage system currently used by the general hospital of Viborg County, Denmark. According to the trauma triage system, an isolated high-energy trauma leads to a trauma team call. The aim of the study was to determine whether a high-energy trauma patient with no symptoms of injury is a sufficient indication to lead to a trauma team call. MATERIALS AND METHODS: The study was based on prospective registration of traumatised patients admitted to the hospital during the period from 1 March 2000 to 28 February 2003. A ROC curve analysis was used to validate the ability of the trauma points to predict severe injury by isolated high-energy traumas. RESULTS: The study included 514 trauma patients, 304 of whom had suffered high-energy traumas. The positive predictive value of a trauma team call was 45% of severe injury. Among the subgroup of patients with no immediate symptoms, the positive predictive value was 15%. The ROC curve analysis found the optimum cut point to be a high-energy trauma with at least one symptom of injury. The sensitivity was 70% and the specificity 52%. CONCLUSION: The study suggests that a high-energy trauma patient showing no symptoms of injury is not a sufficient indication to lead to a trauma team call. This has caused a change in the scoring system. A trauma team call based on a high-energy trauma now implies that the patient shows signs of at least one symptom of injury.