Comparison of Triage Score and Triage-Revised Trauma Score for Triage in Emergent Trauma Patients

ABSTRACT

BACKGROUND: The triage-revised trauma score(t-RTS) is used for triage in trauma patients in many countries. Recently, the triage score was developed as a new triage method for trauma patients in Korea. The objective of this study was to assess the accuracy of triage for the t-RTS and the triage score. METHODS: The medical records of 1575 consecutive trauma patients visiting the Emergency Center, Masan Samsung Hospital, from March to August 1999 were retrospectively analyzed. The triage score and the t-RTS were taken from the charts completed by the emrgency room doctors and nurses. The accuracies of the two triage methods were compared by using the undertriage and the overtriage rates, receiver operating characteristic(ROC) curve analysis, and a correlation analysis with many physiologic, anatomical, biochemical, and mixed scores(Glasgow coma scale, injury severity score, TRISS, APACHE II and III scores, operation, survival, etc.). RESULTS: The undertriage rates for the triage score and the t-RTS were 22.8% and 38.2%, r e s p e c t i v e l y ( ptriage rates were 91.3% and 91.7%, respectively. The areas under ROC curves for the triage score and the t-RTS were 0.871+/-0.033 and 0.800+/-0.039, respectively(95% confidence interval, p<0.001). In general, the correlations of the two triage methods with many physiologic, anatomical, biochemical, and mixed scores were moderately high, but there were no statistical differences between the correlation coefficients of the two triage methods for those scores.

CONCLUSION:

The triage score was equal or superior to the t-RTS for triage in trauma patients. The former was simpler and could be used easily by emergency medical personnel. Therefore, the authors conclude that the triage score can be used instead of the t-RTS for triage in trauma patients.