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Identifying Trauma Patients in Need for Emergency Surgery in the Prehospital Setting: The Prehospital Prediction of In-Hospital Emergency Treatment (PROPHET) Study.

Authors :
Isgrò, Stefano
Giani, Marco
Antolini, Laura
Giudici, Riccardo
Valsecchi, Maria Grazia
Bellani, Giacomo
Chiara, Osvaldo
Bassi, Gabriele
Latronico, Nicola
Cabrini, Luca
Fumagalli, Roberto
Chieregato, Arturo
Sammartano, Fabrizio
Sechi, Giuseppe
Zoli, Alberto
Pagliosa, Andrea
Palo, Alessandra
Valoti, Oliviero
Carlucci, Michele
Benini, Annalisa
Source :
Journal of Clinical Medicine. Oct2023, Vol. 12 Issue 20, p6660. 12p.
Publication Year :
2023

Abstract

Prehospital field triage often fails to accurately identify the need for emergent surgical or non-surgical procedures, resulting in inefficient resource utilization and increased costs. This study aimed to analyze prehospital factors associated with the need for emergent procedures (such as surgery or interventional angiography) within 6 h of hospital admission. Additionally, our goal was to develop a prehospital triage tool capable of estimating the likelihood of requiring an emergent procedure following hospital admission. We conducted a retrospective observational study, analyzing both prehospital and in-hospital data obtained from the Lombardy Trauma Registry. We conducted a multivariable logistic regression analysis to identify independent predictors of emergency procedures within the first 6 h from admission. Subsequently, we developed and internally validated a triage score composed of factors associated with the probability of requiring an emergency procedure. The study included a total of 3985 patients, among whom 295 (7.4%) required an emergent procedure within 6 h. Age, penetrating injury, downfall, cardiac arrest, poor neurological status, endotracheal intubation, systolic pressure, diastolic pressure, shock index, respiratory rate and tachycardia were identified as predictors of requiring an emergency procedure. A triage score generated from these predictors showed a good predictive power (AUC of the ROC curve: 0.81) to identify patients requiring an emergent surgical or non-surgical procedure within 6 h from hospital admission. The proposed triage score might contribute to predicting the need for immediate resource availability in trauma patients. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20770383
Volume :
12
Issue :
20
Database :
Academic Search Index
Journal :
Journal of Clinical Medicine
Publication Type :
Academic Journal
Accession number :
173320159
Full Text :
https://doi.org/10.3390/jcm12206660