PMID- 32396513
OWN - NLM
STAT- MEDLINE
DCOM- 20200601
LR  - 20200601
IS  - 0001-5415 (Print)
IS  - 0001-5415 (Linking)
VI  - 87
IP  - 2
DP  - 2020
TI  - [Comparison of Trauma Triage System in Prehospital Care Based on the Clinical 
      Parameters with the ISS Score in Severely Injured Patients in the Czech 
      Republic].
PG  - 120-126
AB  - PURPOSE OF THE STUDY The purpose of the study is to verify the sensitivity of 
      pre-hospital triage algorithm used in the Czech Republic, which decides on 
      directing the patients at risk of a failure of vital functions into a trauma 
      centre. Another aim is to find out whether the triage algorithm extension by 
      items F4-persistent traumatic paralysis and M7-buried under heavy objects, 
      implemented in 2015, resulted in an increased sensitivity of triage. MATERIAL AND 
      METHODS It is a retrospective, observational, monocentric study. Included in the 
      study were all the trauma patients with the National Advisory Committee on 
      Aeronautics (NACA) score 3-6 treated in the given period, directed by the 
      emergency medical service to the trauma centre. Two groups of patients were 
      compared. In the first group, triage was performed in line with the Bulletin of 
      the Ministry of Health of 2008, while in the second group it was performed in 
      line with the updated version published in the Bulletin of the Ministry of Health 
      in 2015. Both the groups were later compared with the Injury Severity Score (ISS) 
      obtained after the diagnosis of injury in the Trauma Centre of the University 
      Hospital Ostrava. In the second group, also certain selected parameters were 
      assessed. Group A: Patients treated by the Emergency Medical Service of the 
      Moravia-Silesia Region in the period from 1 January 2013 to 31 December 2014 who 
      met the NACA 3-6 criterion and were identified by paramedics as triage positive 
      in line with the pre-hospital triage 2008. Group B: Patients treated by the 
      Emergency Medical Service of the Moravia-Silesia Region in the period from 1 
      January 2016 to 31 December 2017 who met the NACA 3-6 criterion and were 
      identified by paramedics as triage positive in line with the pre-hospital triage 
      2015. In Group B, also monitored was the number of patients identified as triage 
      positive only based on F4 and M7. RESULTS The first group included 3,475 
      patients, of whom 435 were triage positive. In the respective period, the Trauma 
      Centre of the University Hospital Ostrava identified 262 patients with ISS 
      greater than 15 points. The pre-hospital triage and ISS greater than 15 points 
      corresponded in 210 patients. 19.9% were false negative (52/262). The mean ISS 
      was 33.1+/-9.4, median 34, IQR 25.5--1. In Group A, the sensitivity of triage 
      criteria reached 80.2% (95% IS: 74.7-84.7%), the specificity was 93.0% (95% IS: 
      92.0-93.8%). The second group included 3,816 patients, of whom 586 were triage 
      positive. In the monitored period, the Trauma Centre of the University Hospital 
      Ostrava identified 363 patients with ISS greater than 15 points. The pre-hospital 
      triage and ISS greater than 15 points corresponded in 313 patients. 13.8% were 
      false negative (50/363). The mean ISS was 43.7+/-12.0, median 42, IQR 33-54. In 
      Group B, the sensitivity of triage criteria reached 86.2% (95% IS: 82.1-89.5%), 
      the specificity was 98.5% (95% IS: 97.9-98.8%). In Group B, 11 patients were 
      identified as triage positive based on F4 and M7 items. No statistically 
      significant difference was found (chi-squared test, p = 0.257) after adding the 
      F4 and M7 items to the algorithm. CONCLUSIONS The triage system for pre-hospital 
      care in the Czech Republic in line with the applicable pre-hospital triage has 
      high sensitivity as well as specificity and the results correspond to the latest 
      triage algorithms used abroad. Increased sensitivity as a result of adding the 
      new triage items was not confirmed. Key words: pre-hospital triage.
FAU - Holes, D
AU  - Holes D
AD  - Jesseniova lekarska fakulta v Martine, Univerzita Komenskeho v Bratislave.
FAU - Jecminkova, R
AU  - Jecminkova R
FAU - Bursa, F
AU  - Bursa F
LA  - cze
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
PT  - Validation Study
TT  - Porovnani traumatologickeho triazniho systemu v prednemocnicni peci zalozeneho na 
      klinickych parametrech s ISS skore u tezce zranenych pacientu v Ceske republice.
PL  - Czech Republic
TA  - Acta Chir Orthop Traumatol Cech
JT  - Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
JID - 0407123
SB  - IM
MH  - Algorithms
MH  - Czech Republic
MH  - Emergency Medical Services/methods/*standards
MH  - Humans
MH  - *Injury Severity Score
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - Trauma Centers/organization & administration/*standards
MH  - Triage/methods/*standards
MH  - Wounds and Injuries/*diagnosis/*therapy
EDAT- 2020/05/13 06:00
MHDA- 2020/06/02 06:00
CRDT- 2020/05/13 06:00
PHST- 2020/05/13 06:00 [entrez]
PHST- 2020/05/13 06:00 [pubmed]
PHST- 2020/06/02 06:00 [medline]
PST - ppublish
SO  - Acta Chir Orthop Traumatol Cech. 2020;87(2):120-126.