Is Overtriage Associated With Increased Mortality? The Evidence Says “Yes”

Research in disaster medicine in general, and triage in particular, is largely descriptive and conducted after the fact because disasters do not lend themselves to study via randomized controlled trials. A useful alternative involves modeling and analysis based on parameters obtained from real disasters. Triage is particularly appropriate for this kind of analysis because it involves a relatively distinct problem space, with discrete decisions made at well-defined points in time. Defining and varying the inputs into particular triage schemes should therefore permit model predictions across a variety of scenarios. In particular, the effects of overtriage, or labeling noncritical casualties as critical, could be demonstrated relative to critical mortality, or the mortality of critical casualties with an Injury Severity Score (ISS) of 15. The results of this modeling could then be applied to planning and practice.