ArticleTrauma surgery & acute care open2026
Secondary overtriage: impact of trauma center designation and trauma system integration.
Article in Trauma surgery & acute care open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
- Dousing the dumpster fire of secondary overtriage.Trauma surgery & acute care open · 2026Article
Corrections and comments
- Commented on by
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Secondary overtriage in trauma refers to the interfacility transfer of minimally and moderately injured patients who do not require major interventions, resulting in short stays at tertiary receiving facilities. Secondary overtriage rates are commonly used as a measure of trauma system efficiency, focused on the optimal allocation and use of healthcare resources. However, limited data exist examining the impact of Level III trauma centers (L3TC) on secondary overtriage rates. Therefore, this study aimed to determine whether transfer from L3TCs, compared with non-trauma facilities, was associated with a lower rate of secondary overtriage among patients subsequently admitted to a Level I trauma center. Methods: This was a single-center, retrospective cohort study of trauma patients transferred to a tertiary trauma center between 1 August 2021 and 31 July 2023. The primary exposure was the American College of Surgeons-verified or state-designated trauma center level of the referring facilities. Multiple variable regression analysis was applied to three models: (1) unadjusted, (2) adjusted for patient characteristics and (3) adjusted for patient and hospital characteristics. Results: A total of 2309 patients were transferred to our tertiary trauma center from 20 referring facilities, including 15 non-L3TCs and 5 L3TCs. Secondary overtriage rates were significantly lower at L3TCs (23.5% vs 28.4%, p=0.009). On multivariable regression analysis, even after adjusting for patient and hospital characteristics, the odds of secondary overtriage from non-L3TCs remained 31% higher compared with L3TCs (OR: 1.31 (1.02, 1.67)). Non-L3TC transfer patients had a 12% shorter average hospital length of stay (LOS), a 21% shorter average intensive care unit LOS, and a 39% shorter average ventilator LOS (all p<0.05). Conclusions: In this study, secondary overtriage rates were significantly lower for L3TCs compared with non-L3TCs, even after adjusting for patient and hospital characteristics. These findings suggest that L3TCs benefit from state-mandated healthcare resource investment and trauma system integration. Level of evidence: Level III, Therapeutic/Care Management.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.