The trauma triage rule: a new, resource-based approach to the prehospital identification of major trauma victims.

STUDY OBJECTIVE To develop a new trauma decision rule. DESIGN Retrospective clinical review. SETTING Level I trauma center. TYPE OF PARTICIPANTS 1,004 injured adults. MEASUREMENTS AND MAIN RESULTS A new trauma decision rule was derived from 1,004 injured adult patients using a new operational definition of major trauma. The rule, termed the Trauma Triage Rule, defines a major trauma victim as any injured adult patient whose systolic blood pressure is less than 85 mm Hg; whose motor component of the Glasgow Coma Score is less than 5; or who has sustained penetrating trauma of the head, neck, or trunk. Using the operational definition of major trauma, the rule had a sensitivity of 92% and a specificity of 92% when tested on the 1,004-patient cohort. CONCLUSION The Trauma Triage Rule may significantly reduce overtriage while only minimally increasing undertriage. This approach must be validated prospectively before it can be used in the prehospital setting.

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