• R J Bond, J B Kortbeek, and R M Preshaw.
• Department of Surgery, University of Calgary, Alberta, Canada.
• J Trauma. 1997 Aug 1;43(2):283-7.

BackgroundThe objective of this study was to combine a physiologic triage score (prehospital index, PHI) with criteria regarding mechanism of injury (MOI) to increase the efficacy of trauma triage. The specific question being asked was: will the combined score improve the sensitivity and specificity over that of the individual scores?MethodsIn this prospective study, 3,147 injury patients (all adults > or = 14 years) were reviewed. Each patient received a PHI score and a MOI score in the field, which were compared with their Injury Severity Score (ISS) at separation. An ISS > or = 16 was defined as major trauma.ResultsPHI alone had a sensitivity of 41%, MOI alone had a sensitivity of 73%, whereas the combined PHI/MOI score had a sensitivity of 78%. All three had similar specificities. These findings were statistically significant (p < or = 0.001).ConclusionThe combined PHI/MOI score was better at identifying those patients with ISS scores > or = 16 compared with the PHI and MOI scores alone. Although this permitted superior triage (and minimized overtriage), the combined score did not identify all major trauma patients.

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