ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022
Changing from a two-tiered to a one-tiered trauma team activation protocol: a before-after observational cohort study investigating the clinical impact of undertriage.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Evaluating performance and potential clinical benefit of the Swedish On Scene Injury Severity Prediction (OSISP) model for prehospital field triage on Norwegian trauma data.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Evaluation of the trauma criteria from the Norwegian national trauma plan: an observational study from a regional trauma centre.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Observational
- Prevalence, characteristics and treatment of concomitant injury to liver and spleen with vascular injury after blunt abdominal trauma.Scientific reports · 2025Article
- Adherence to national trauma triage criteria in Norway: a cross-sectional study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Observational
- Injury Severity Score Precision for Determining Undertriage in Trauma Consultation Patients: A Retrospective Study.Cureus · 2024Article
- Article
- Characteristics and demography of low energy fall injuries in patients > 60 years of age: a population-based analysis over a decade with focus on undertriage.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Time Delay in Motor Vehicle Accident Arrival: A Critical Analysis of Trauma Team Activation.Cureus · 2024Article
- Resource Deployment in Response to Trauma Patients.Cureus · 2023Article
- Characteristics, image findings and clinical outcome of moderate and severe traumatic brain injury among severely injured children: a population-based cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Observational
- Incidence, Mechanisms of Injury and Mortality of Severe Traumatic Brain Injury: An Observational Population-Based Cohort Study from New Zealand and Norway.World journal of surgery · 2022Observational
- A prospective study comparing two methods of pre-hospital triage for trauma.Updates in surgery · 2022Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study was to compare the effect of the change in TTA protocol from a two-tier to one-tier, with focus on undertriage and mortality. MATERIAL AND
methodsA before-after observational cohort study based on data extracted from the Stavanger University Hospital Trauma registry in the transition period from two-tier to a one-tier TTA protocol over two consecutive 1-year periods (2017-2018). Comparative analysis was done between the two time-periods for descriptive characteristics and outcomes. The main outcomes of interest were undertriage and mortality.
resultsDuring the study period 1234 patients were included in the registry, of which 721 (58%) were in the two-tier and 513 (42%) in the one-tier group. About one in five patients (224/1234) were severely injured (ISS > 15). Median age was 39 in the two-tier period and 43 years in the one-tier period (p = 0.229). Median ISS was 5 for the two-tier period vs 9, in the one-tier period (p = 0.001). The undertriage of severely injured patients in the two-tier period was 18/122 (15%), compared to 31/102 (30%) of patients in the one-tier period (OR = 2.5; 95% CI 1.8-4.52). Overall mortality increased significantly between the two TTA protocols, from 2.5 to 4.7% (p = 0.033), OR 0.51 (0.28-0.96)
conclusionA protocol change from two-tiered TTA to one-tiered TTA increased the undertriage in our trauma system. A two-tiered TTA may be beneficial for better patient care.
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