TY - JOUR T1 - Establishment of a novel triage system for SARS-CoV-2 among trauma victims in trauma centers with limited facilities JF - Trauma Surgery & Acute Care Open JO - Trauma Surg Acute Care Open DO - 10.1136/tsaco-2021-000726 VL - 6 IS - 1 SP - e000726 AU - Hossein Abdolrahimzadeh Fard AU - Roham Borazjani AU - Golnar Sabetian AU - Zahra Shayan AU - Shahram Boland Parvaz AU - Hamid Reza Abbassi AU - Shiva Aminnia AU - Maryam Salimi AU - Shahram Paydar AU - Ali Taheri Akerdi AU - Masome Zare AU - Leila Shayan AU - Salahaddin Mahmudi-Azer Y1 - 2021/06/01 UR - http://tsaco.bmj.com/content/6/1/e000726.abstract N2 - Objectives The triage of trauma patients with potential COVID-19 remains a major challenge given that a significant number of patients may be asymptomatic or pre-symptomatic. This study aimed to compare the specificity and sensitivity of available triage systems for COVID-19 among trauma patients. Furthermore, it aimed to develop a novel triage system for SARS-CoV-2 detection among trauma patients in centers with limited resources.Methods All patients referred to our center from February to May 2020 were enrolled in this prospective study. We evaluated the SARS-CoV-2 triage protocols from the WHO, the Iranian Ministry of Health and Medical Education (MOHME), and the European Centre for Disease Control and Prevention (ECDC) for their effectiveness in finding COVID-19 infected individuals among trauma patients. We then used these data to design a stepwise triage protocol to detect COVID-19 positive patients among trauma patients.Results According to our findings, the WHO protocol showed 100% specificity and 13.3% sensitivity. The MOHME protocol had 99% specificity and 23.3% sensitivity. While the ECDC protocol showed 93.3% sensitivity and 89.5% specificity, it did not prioritize patients based on traumatic injuries and unstable conditions. Our stepwise triage protocol, which prioritizes traumatic injuries, had 93.3% sensitivity and 90.3% specificity.Conclusion Our study shows that the triage protocols from the WHO, MOHME and ECDC are not best equipped to diagnose SARS-CoV-2 infected individuals among trauma patients. In our proposed stepwise triage system, patients are triaged according to their hemodynamic conditions, COVID-19 related clinical states, and COVID-19 related laboratory findings. Our triage model can lead to more accurate and resource-effective management of trauma patients with potential COVID-19 infection.Level of evidence Level Ⅲ.Data are available upon reasonable request. No free text required. ER -