• M J Zimmer-Gembeck, P A Southard, J R Hedges, R J Mullins, D Rowland, J V Stone, and D D Trunkey.
• Trauma Program, Oregon Health Sciences University, Portland 97201, USA.
• J Trauma. 1995 Nov 1;39(5):922-8.

ObjectiveThe goal of this study was to determine patient and injury characteristics that predict undertriage and overtriage.DesignThis study was a retrospective analysis of admissions for acute injury.Materials And MethodsAll admissions for acute injuries in a 2 1/2-year period were included (N = 26,025). ICD-9 clinical modification codes were converted to Injury Severity Scores.Main ResultsSeventy-nine percent of severely injured patients were admitted to level I trauma centers. Severely injured patients admitted to other hospitals (undertriage) were more likely elderly (odds ratio = 5.44) and less likely had multisystem injuries (odds ratio = 0.55). One-fourth of patients with minor injuries were admitted to level I trauma centers (overtriage). Overtriaged patients were more likely intoxicated, obese, or had an injury to the head or face.ConclusionsIn a developed trauma system, severely injured elderly trauma patients (especially females) are at risk for undertriage. The characteristics of patients at risk for overtriage reflect the difficulties of prospective out-of-hospital triage.

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