Evidence map›Paper›PMID 41719531›Full record

Observational studyJournal of trauma nursing : the official journal of the Society of Trauma Nurses

Impact of Increasing Numbers of Trauma Activation Criteria on Outcomes and Resource Utilization: A Multicenter Study.

Nina Y Wilson, Harun Mazumder, Gina M Berg, Andrea Slivinski, Jessica M Cofran, Tracy J Johns, Jeffry Nahmias, Haytham Kaafarani, Julie A Dunn, Shawn Moreau and 13 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of trauma nursing : the official journal of the Society of Trauma Nurses. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Nina Y WilsonAuthor Affiliations: Clinical Operations Group, Center for Trauma and Acute Care Surgery Research, HCA Healthcare, Nashville, Tennessee (Ms Wilson, Dr Mazumder, Dr Garland, Ms Harbour, Dr Shen, Dr Orlando, and Dr Fakhry); Department of Trauma Services, Wesley Healthcare, Wichita, Kansas (Dr Berg); Department of Trauma Services, Mission Hospital, Asheville, North Carolina (Dr Slivinski); Department of Trauma Services, CommonSpirit Mountain Region, Lakewood, Colorado (Ms Cofran); Department of Surgery and Trauma, Atrium Health Navicent Medical Center, Macon, Georgia (Ms Johns); Department of Surgery, University of California, Irvine, California (Dr Nahmias); Massachusetts General Hospital, Harvard University, Harvard Medical School and Massachusetts General Brigham (MGB), Boston, Massachusetts (Dr Kaafarani); Department of Trauma and Acute Care Surgery; University of Colorado Health Medical Center of the Rockies, Loveland, Colorado (Dr Dunn); Department of Trauma, Rapides Regional Medical Center, Alexandria, Louisiana (Dr Moreau); Department of Trauma Services, Northeast Georgia Medical Center, Gainesville, Georgia (Ms Krause); Department of Trauma Services, Duke University Hospital; Durham, North Carolina (Ms Durst); Department of Trauma and Acute Care Surgery, University of Colorado Health Medical Center of the Rockies, Loveland, Colorado (Ms Cotner-Pouncy); Department of Trauma Services, HCA Florida Lawnwood Hospital, Ft. Pierce, Florida (Ms Mitchell); Department of Trauma Services, MedStar Washington Hospital Center, Washington, District of Columbia (Ms Kennedy); Department of Trauma, North Oaks Medical Center, Hammond, Louisiana (Ms Gennusa); and Ochsner Lafayette General Medical Center, Lafayette, Louisiana (Ms Klentzman Heard).ORCID 0000-0002-2560-7779
Harun MazumderORCID 0009-0006-4664-8496
Gina M BergORCID 0000-0001-7311-8446
Andrea SlivinskiORCID 0000-0003-1397-3904
Jessica M CofranORCID 0000-0002-6550-4790
Tracy J JohnsORCID 0000-0001-5890-8044
Jeffry NahmiasORCID 0000-0003-0094-571
Haytham KaafaraniORCID 0000-0002-4682-9135
Julie A DunnORCID 0000-0002-9381-9060
Shawn MoreauORCID 0009-0008-0577-3463
Morgan KrauseORCID 0000-0002-8751-5757
Georgina DurstORCID 0009-0007-1087-5803
Tracy Cotner-PouncyORCID 0009-0005-3002-4366
Susi MitchellORCID 0009-0007-7026-6997
Susan KennedyORCID 0000-0002-7019-4993
Jodi GennusaORCID 0009-0003-4056-5321
Ali Klentzman Heard
Jeneva M GarlandORCID 0000-0003-4920-3020
Lori F HarbourORCID 0000-0003-3207-5325
Yan ShenORCID 0000-0002-1372-5874
Alessandro OrlandoORCID 0000-0003-2900-3988
Samir M FakhryORCID 0000-0002-6781-0863
Geriatric Trauma Activation Criteria Research Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe American College of Surgeons mandates eight trauma activation criteria for full trauma activations, yet many centers exceed this number to minimize undertriage. The association between trauma activation criteria and triage accuracy and resource use is poorly studied.

objectiveTo assess the relationship between the number of criteria for full trauma activation and rates of activation, undertriage, overtriage, mortality, and hospital length of stay.

methodsThis multicenter retrospective cohort study analyzed survey and trauma registry data from 36 trauma centers across 16 U.S. states and the District of Columbia. Centers reported their activation criteria used for full trauma activation from 2017 to 2019, and outcomes were evaluated using multivariable negative binomial regression and weighted linear regression.

resultsAmong 218,832 patients, the number of trauma activation criteria per center ranged from 8 to 28, with a mean of 16.75 and an SD of 4.47. The number of criteria was not significantly associated with the proportion of full trauma activation (adjusted incidence rate ratio [aIRR] = 1.02 [95% CI 0.996, 1.05], p = .097), undertriage (aIRR = 0.98 [95% CI 0.96, 1.003], p = .081), mortality (aIRR = 1.00 [95% CI 0.99, 1.01]; p = .952), or length of stay ( b = -0.001 [95% CI -0.059, 0.058], p = .985). However, more criteria were significantly associated with greater overtriage (aIRR = 1.02 [95% CI 1.003, 1.03], p = .010).

conclusionIncreasing the number of trauma activation criteria was not linked to improved undertriage or clinical outcomes, but was associated with higher overtriage, suggesting a greater burden on trauma resources without clinical benefit.

Indexed as

Trauma CentersTriageWounds and InjuriesAdultFemaleHumansInjury Severity ScoreLength of StayMaleMiddle AgedRegistriesRetrospective StudiesUnited StatesActivation fatigueOvertriageTrauma activationTrauma activation criteriaUndertriage

Identifiers

PMID41719531
PMCPMC12959589

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