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Charles H. Cook, MD; Peter Muscarella, MD; Anant C. Praba, MD; W. Scott Melvin, MD; Larry C. Martin, MD

Arch Surg. 2001;136:752-756.

Hypothesis  Changing category 1 criteria to include primarily physiologic and anatomic indicators of injury, eliminating mechanism of injury criteria, decreases the rate of overtriage without compromising outcomes.

Methods  Retrospective review of our American College of Surgeons–verified level I trauma registry from January 1, 1996, to December 31, 1998, comparing patients before and after trauma alert criteria changes.

Results  There was a significant decrease in category 1 alerts, representing a reduction in overtriage. There was a concomitant increase in injury severity and mortality in category 1 patients. There was no significant change in injury severity or mortality for category 2 patients.

Conclusions  There was a significant reduction in overtriage of trauma patients demonstrated without an appreciable impact on patient outcome. Changing trauma response criteria to more physiologic and anatomic indicators allowed improved triage of trauma patients, which improves resource allocation.

From the Department of Surgery, The Ohio State University Medical Center, Columbus.

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