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Level of undertriage in a well established Trauma Registry in Denmark
  1. A K Haug*,
  2. T Wilson*,
  3. M S Larsen,
  4. J M Lauritsen
  1. Correspondence Orthopaedic Department, Accident Analysis Group, Odense University Hospital, Sdr Boulevard, 29 Odense DK5000 C, Denmark

Abstract

Background Triage is the correct admission of injured patients to a suitable treatment level. Previously no studies were done for the trauma registry at Odense University Hospital (OUH) in Denmark established in 1996. Aim was to assess level and character of undertriage.

Method Retrospective analysis of data collected from OUHs list of patients admitted with ICD S- and T-diagnoses in 2007. Inclusion criteria is ISS>15, treated in intensive care >2 days, dead within 30 days, or proximal penetrating injury. Over-triage was identified on the basis of the trauma registry for patients received by the trauma team, where the severely injured patient was defined as ISS>15 or proximal penetrating injury. In total 747 trauma patients were received in 2007, 21% with ISS>15.

Results Undertriage including death within 30 days was 22%, without these, 11%. Women had a higher risk of undertriage than men, and undertriaged patients were significantly older than correctly triaged patients. We discovered a high frequency of falls from low heights in undertriaged patients. 628 patients were admitted by the trauma team, with an over-triage of 82%.

Conclusion We found an undertriage proportion comparable to similar studies. Elderly patients and women had a higher risk of being undertriaged, which also has been shown in other studies. We believe further research should be concentrated on the reasons for the high under and over-triage, by investigating current systems and routines, and to research whether the elderly and comorbid would reap benefit from medical participation in early treatment.

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