Evaluation of Secondary Overtriage at a Rural Level 1 Trauma Center.

Autor:	Osher J; Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA., Archer A; Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA., Heard MA; Department of Surgery, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA., McBride ME; Department of Surgery, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA., Leonard M; Department of Surgery, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA., Burns JB; Department of Surgery, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2024 Sep; Vol. 90 (9), pp. 2244-2248. Date of Electronic Publication: 2024 Jun 14.
DOI:	10.1177/00031348241262429
Abstrakt:	Objective: To retrospectively assess the prevalence of secondary overtriage (SO) within a rural regional Appalachian health care system. Methods: Trauma registry data was extracted for all trauma activation transfer patients from 2017 to 2022. Transferred patients were then stratified into two groups, non-secondary overtriage (non-SO) or SO. Patients were considered SO if they met three criteria following transfer: an Injury Severity Score (ISS) of less than 15, no required operative intervention, and discharge within 48 hours of arrival. Descriptive statistics were compared for age, length of stay (LOS), ICU LOS, and ISS. Surgical subspecialty consultations were compared between the two groups. Patients in the SO group were further assessed by body region of injury and Abbreviated Injury Score (AIS). Results: Among 3,291 trauma activation transfer patients, 43% (1,407) were considered SO transfers. Patients in the SO group were significantly younger, had shorter average hospital and ICU LOS, and lower ISS compared to the non-SO group. Additionally, 25.7% of patients in the SO group had injuries to the head or neck of which 8.96% have an AIS ≥3. 21% of patients had injuries to the face, with 0.14% having an AIS ≥3. Conclusions: 43% of transfer patients in this study met our definition of SO. Although no optimal rate of SO has been universally established, limiting SO stands to benefit both patients and trauma systems. This study highlights how institutional analysis of transfer patients may help inform transfer protocols to reduce secondary overtriage and overutilization of scarce resources. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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