• 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, and Tobias Gauss.
• Department of Anesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP.Nord, Paris, France. paer-selim.abback@aphp.fr.
• Eur J Trauma Emerg Surg. 2022 Apr 1; 48 (2): 1061-1068.

PurposeThe 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.MethodsRetrospective 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).ResultsOf 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.ConclusionThis 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.© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.

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