Introduction: Over and under-triage represent a misallocation of resources that can affect patient outcomes. The purpose of this study is to evaluate over and under-triage rates in relation to risk factors and associated outcomes of trauma patients nationwide.
Methods: A retrospective cohort study using the Trauma Quality Improvement Program from 2017 to 2020. Multivariable regression models were used to assess predictors of over-triage (activation when unnecessary) and under-triage (limited activation when full activation was necessary).
Results: 22.2 % (32,782) of the study population were over-triaged and 20.3 % (29,996) were under-triaged. Most over-triaged patients were Black, with Medicaid, or had a penetrating injury, whereas most under-triaged patients were White, with private/commercial insurance, or had a blunt injury. With covariates adjusted for, Pacific Islander (p = 0.024) and American Indian patients (p = 0.015) were associated with higher odds of over-triage, and Hispanic patients had higher odds of under-triage (p<0.001). Patients with Medicare (p<0.001) had higher odds of over-triage, and patients with private/commercial insurance (p<0.001) had higher odds of under-triage compared to Medicaid patients. Patients in level II (p<0.001) and level III (p<0.001) trauma hospitals were associated with higher odds of over-triage.
Conclusion: Pacific Islander and American Indian patients, Medicare, and level II and III trauma centers are at increased risk of over-triage rates, while Hispanic and privately insured trauma patients had a higher risk for under-triage. Future studies should further investigate factors contributing to poor outcomes linked to under-triage practices and methods to improve consistency and standardization of triage tools across various levels of trauma centers.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.injury.2023.111215 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Traumatic Brain Injury Patients Admitted on High-Census Days Receive Less Critical Care and Have an Increased Risk for Delirium.
Cureus
August 2024
Department of Trauma and Acute Care Surgery, Sanford Medical Center Fargo, Fargo, USA.
Introduction: The utilization of healthcare services in a growing population has raised concerns about its impact on clinical outcomes. Studies have shown that increased hospital census is associated with higher admission rates and unnecessary consults, tests, and procedures in various areas of healthcare. Traumatic brain injuries (TBIs), a significant concern due to their potential for long-term disabilities, are commonly encountered in intensive care units (ICUs) and are a leading cause of patient mortality.
View Article and Find Full Text PDFEmergency Patient Triage Improvement through a Retrieval-Augmented Generation Enhanced Large-Scale Language Model.
Prehosp Emerg Care
July 2024
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Article Synopsis
- This study evaluates how integrating Retrieval Augmented Generation (RAG) with large language models (LLMs), like OpenAI's GPT-3.5, can improve the triage process in emergency medical care.
- Researchers created 100 simulated emergency scenarios to test the triage accuracy of RAG-enhanced LLMs against emergency medical technicians (EMTs) and physicians, finding the LLMs achieved a 70% correct triage rate compared to 35% and 50%, respectively.
- The results suggest that using RAG with LLMs can significantly reduce under-triage rates and improve the consistency of emergency medical assessments, indicating the need for further testing in real-life settings.
Impact of triage nurses' recognition of acute coronary syndrome on patients' clinical outcomes: A retrospective study.
Heart Lung
October 2024
Department of Medical Surgical Nursing, College of Nursing, Prince Sattam bin Abdulaziz University, AlKharj, Saudi Arabia.
Background: Triage nurses' pivotal role in initial assessment makes their competence crucial. However, the specific impact on Acute Coronary Syndrome (ACS) recognition and outcomes remains unclear in Jordanian healthcare. Understanding this relationship could enhance ACS management and patient outcomes in Jordanian Emergency Departments (EDs).
View Article and Find Full Text PDFCutoff of the reverse shock index multiplied by the Glasgow coma scale for predicting in-hospital mortality in adult patients with trauma: a retrospective cohort study.
BMC Emerg Med
April 2024
Department of Emergency Medicine, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, 03722, Seoul, Republic of Korea.
Article Synopsis
- * This study analyzed data from 318,506 trauma patients across 23 South Korean emergency departments to determine rSIG cutoff values corresponding to increased in-hospital mortality.
- * Findings suggest an rSIG cutoff of 16.5 indicates higher risk of mortality in trauma patients, while in those with traumatic brain injuries, an rSIG over 25 shows a similar trend, highlighting the need for future research on specific cutoffs for this group.
Article Synopsis
- Triage accuracy is crucial for effective pediatric trauma care, with this study exploring factors leading to under- and over-triage in an urban trauma center.
- The study analyzed 1,094 trauma cases involving patients under 18 years old from January 2021 to July 2023, finding an under-triage rate of 3.8% and an over-triage rate of 13.6%.
- Key risk factors identified include infants (0-1 years) being most likely to be under-triaged and older teens (11-17 years) being most often over-triaged, with non-accidental trauma linked to under-triage and penetrating injuries associated with over-triage.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!