Undertriage for Blunt Trauma Victims with Deteriorated Short-term Outcome in An Urban Trauma System.

概要

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The practical triage for trauma victims is not organized in Japan yet. To identify the importance of field triage in the city of Yokohama, we studied the influence of undertriage on outcome in seriously blunt trauma victims referred to our advanced trauma center from April 1997 to March 1999. We studied the differences in outcome and inhospital clinical course between patients with an injury severity score (ISS) >15 sent directly from the scene (DT group: n=10) and through interhospital transfer (IT group: n=16). Those two groups showed no difference in age, gender, ISS, revised trauma score (RTS) or abbreviated injury scale (AIS) scores at each injury site. Patients in the IT group who required ICU support experienced relatively longer length (3.7±3.3 vs 9.0±11.2 days, p=0.09) and significantly detrimental outcome estimated as severe disability (SD) on the Glasgow Outcome Scale ((GR or MD)/SD: 8/2 vs 5/11, p=0.04). These results demonstrated that undertriage worsened patient outcome and clinical course. The problem in trauma care will be clarified by further study of undertriage. We should study all trauma incidents, hospital transfer, and outcome in our clinical area in cooperation with the Fire Bureau and establish triage tools as a form of medical control.
一般社団法人日本救急医学会の論文