Triage in an established trauma system

M. J. Zimmer-Gembeck, P. A. Southard, J. R. Hedges, R. J. Mullins, D. Rowl, J. V. Stone, D. D. Trunkey

Research output: Contribution to journalArticlepeer-review

74 Scopus citations


Objective: The goal of this study was to determine patient and injury characteristics that predict undertriage and overtriage. Design: This study was a retrospective analysis of admissions for acute injury. Materials and Methods: All admissions for acute injuries in a 2 1/2 -year period were included (N = 26,025). ICD-9 clinical modification codes were converted to Injury Severity Scores. Main Results: Seventy-nine percent of severely injured patients were admitted to level I trauma centers. Severely injured patients admitted to other hospitals (undertriage) were more likely elderly (odds ratio = 5.44) and less likely had multisystem injuries (odds ratio = 0.55). One-fourth of patients with minor injuries were admitted to level I trauma centers (overtriage). Overtriaged patients were more likely intoxicated, obese, or had an injury to the head or face. Conclusions: In a developed trauma system, severely injured elderly trauma patients (especially females) are at risk for undertriage. The characteristics of patients at risk for overtriage reflect the difficulties of prospective out-of-hospital triage.

Original languageEnglish (US)
Pages (from-to)922-928
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number5
StatePublished - 1995
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine


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