• Marie Louise Clemmesen, Søren Rytter, Kathrine Birch, Jes S Lindholt, Steffen Skov Jensen, and Svend Troelsen.
• Sygehus Viborg, Ortopaedkirurgisk Afdeling, Forskningssektionen Karkirurgisk Afsnit og Anaestesiologisk Afdeling. louiseclemmesen@dadlnet.dk
• Ugeskr. Laeg. 2006 Aug 28; 168 (35): 2916-20.

BackgroundThis study was performed to evaluate the trauma triage system currently used by the general hospital of Viborg County, Denmark. According to the trauma triage system, an isolated high-energy trauma leads to a trauma team call. The aim of the study was to determine whether a high-energy trauma patient with no symptoms of injury is a sufficient indication to lead to a trauma team call.Materials And MethodsThe study was based on prospective registration of traumatised patients admitted to the hospital during the period from 1 March 2000 to 28 February 2003. A ROC curve analysis was used to validate the ability of the trauma points to predict severe injury by isolated high-energy traumas.ResultsThe study included 514 trauma patients, 304 of whom had suffered high-energy traumas. The positive predictive value of a trauma team call was 45% of severe injury. Among the subgroup of patients with no immediate symptoms, the positive predictive value was 15%. The ROC curve analysis found the optimum cut point to be a high-energy trauma with at least one symptom of injury. The sensitivity was 70% and the specificity 52%.ConclusionThe study suggests that a high-energy trauma patient showing no symptoms of injury is not a sufficient indication to lead to a trauma team call. This has caused a change in the scoring system. A trauma team call based on a high-energy trauma now implies that the patient shows signs of at least one symptom of injury.

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