Article Figures & Data
Tables
- Table 1A
Overall overtriage and undertriage rates in our trauma patients
Patients transferred directly to our hospital (by any means of transport) Patients primarily evaluated in a lower level of healthcare facility and then transferred to our hospital (by any means of transport) Overall overtriage (O) Overall
undertriage (U)ISS≤15 n1=2236 n2=8 O=(n1+n2)/ntotal=2244/2320=96.7% U=n4/ntotal=20/2320=1% ISS>15 n3=56 n4=20 LOS≤48 hours and non-operative management and final outcome: hospital discharge n1=2098 n2=6 O=(n1+n2)/ntotal=2104/2320=90.7% U=n4/ntotal=22/2320=1% LOS>48 hours or operative management or final outcome: death n3=194 n4=22 - Table 1B
Accuracy of the prehospital triage provided by the GNMS
Patients transferred directly to our hospital (by the GNMS) Patients transferred from a lower level of healthcare facility to our hospital (by the GNMS) GNMS overtriage (O) ISS≤15 n1=121 n2=6 O=n1/(n1+n3)=121/159=76.1% ISS>15 n3=38 n4=20 LOS≤48 hours and non-operative management and final outcome: hospital discharge n1=90 n2=4 O=n1/(n1+n3)=90/159=56.6% LOS≥48 hours or operative management or final outcome: death n3=69 n4=22 - Table 1C
Application of the EMS triage algorithm in our trauma patients and the impact on the overall overtriage and undertriage
Met the EMS algorithm criteria Did not meet the EMS algorithm criteria Overtriage (O) Undertriage (U) ISS≤15 n1=1036 n2=1208 O=n1/ntotal=1036/2320=44.6% U=n4/ntotal=1/2320=0% ISS>15 n3=75 n4=1 LOS≤48 hours and non-operative management and final outcome: hospital discharge n1=923 n2=1181 O=n1/ntotal=39.7% U=n4/ntotal=28/2320=1.2% LOS≥48 hours or operative management or final outcome: death n3=188 n4=28 EMS, emergency medical service; GNMS, Greek National Medical Services; ISS, Injury Severity Score; LOS, length of hospital stay.
- Table 2A
Trauma outcomes
(n=population of the particular group of trauma patients) Fatalities (mortality %) Overall trauma mortality (2320) 29 (1.3) Prehospital GNMS mortality (185)
(dead upon arrival patients/GNMS transferred patients)8 (4.3) 30 days’ surgical mortality (91) 7 (7.7) ICU mortality (21) 8 (38.1) ISS ≤3 (1785) 2 (0.1) 4–8 (328) 0 (0) 9–15 (131) 3 (2.3) 16–24 (35) 1 (2.9) ≥25 (41) 23 (56.1) - Table 2B
Outcomes of trauma management in our hospital in comparison with the US NTDB
Outcomes Our trauma registry US NTDB P value Trauma patients managed in our hospital
n (%)Trauma patients managed in US trauma centers and non-trauma centers
n (%)Patients’ hospital mortality, with maximal AIS score ≤3 6/2250 (0.3) 134/2744 (4.9) <0.001 Patients’ hospital mortality, with maximal AIS score 4 3/38 (7.9) 174/1368 (12.7) 0.3765 Patients’ hospital mortality43, with maximal AIS score 5–6 20/26 (76.9) 303/931 (32.5) 0.1239 - Table 2C
Outcomes of trauma management in our hospital in comparison with theUS NTDB
Outcome Our trauma registry EuroTARN group n (%) Range Surviving after trauma of an ISS>1526 52/76 (68.4) 24%–100% AIS, Abbreviated Injury Scale; EuroTARN, Trauma Audit and Research Network; GNMS, Greek National Medical Services; ICU, intensive care unit; ISS, Injury Severity Score; NTDB, National Trauma Data Bank.
- Table 3
Cost for diagnosis and management of trauma patients across different injury severity groups and cost of overtriage
(n=population of the particular group of trauma patients) Cost for diagnosis and treatment of patients
(sum of costs)
(% of overall costs)Cost per patient
(mean cost)LOS≤48 hours and non-operative management and final outcome: hospital discharge
(n=2104)€120 761.92
(19.4)€57.4 LOS>48 hours or operative management or final outcome: death
(n=216)€502 377.88
(80.6)€2325.82 Patients (ISS≤15) who should have been transferred to a level III or IV trauma center equal
(n=2244)€314 809.49
(50.5)€140.28 Patients (ISS>15) who should have been transferred to our center (level I/II trauma center equal)
(n=76)€308 330.31
(49.5)€4056.98 Patients who fulfilled the EMS triage algorithm criteria for trauma center transfer
(n=1111)€557 460.63
(89.5)€501.76 Patients who did not fulfill the EMS algorithm criteria for trauma center transfer
(n=1209)€65 679.17
(10.5)€54.32 ISS≤3
(n=1785)€102 619.17
(16.5)€57.49 4≤ISS≤8
(n=328)€60 476.1
(9.7)€184.38 9≤ISS≤15
(n=131)€151 714.22
(24.3)€1158.12 16≤ISS≤24
(n=35)€107 924.91
(17.3)€3083.57 ISS≥25
(n=41)€200 405.40
(32.2)€4887.94 EMS, emergency medical service; ISS, Injury Severity Score; LOS, length of hospital stay.
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