Evidence map›Paper›PMID 42848131›Full record

ArticleCJEM2026

Performance of updated American College of Surgeons field triage guidelines in identifying need for trauma center care.

Ian V Beamish, David J Friedman, Rosane Nisenbaum, Ian R Drennan, Daniel Gold-Bersani, Pierre-Marc Dion, Melissa McGowan, Brodie Nolan

Abstract read
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Article in CJEM, 2026. 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

8 authors.

Ian V BeamishDivision of Emergency Medicine, University of Toronto, Toronto, ON, Canada.
David J FriedmanMelbourne Medical School, University of Melbourne, Melbourne, VIC, Australia.
Rosane NisenbaumApplied Health Research Centre, MAP Centre for Urban Health Solutions, Toronto, ON, Canada.
Ian R DrennanDepartment of Emergency Services and Sunnybrook Research Institute, Sunnybrook Health Science Center, Toronto, ON, Canada.
Daniel Gold-Bersani. George's University School of Medicine, West Indies, Grenada.
Pierre-Marc DionFaculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Melissa McGowanDepartment of Emergency Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Brodie NolanDivision of Emergency Medicine, University of Toronto, Toronto, ON, Canada. brodie.nolan@unityhealth.to.ORCID http://orcid.org/0000-0003-2872-0643

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe Guidelines for the Field Triage of injured patients were updated in 2021 to improve the reliability of prehospital trauma triage. The objective of this study was to describe the association of the 2021 Field Triage Guidelines criteria with need for advanced trauma center care from a cohort of patients transported to a level 1 trauma center.

methodsThis was a health records review of Field Triage Guidelines criteria met for trauma team activations at a level 1 trauma center from January 2020 to December 2021. Hospital-based and injury severity score (ISS)-based trauma center need were defined and sensitivity and specificity of the Field Triage Guidelines calculated for both. Area under the receiver operator curves were used to assess accuracy. Multivariable logistic regression was used to evaluate the association of each criterion with trauma center need.

resultsA total of 1427 patients were included and 90.3% met at least one Field Triage Guidelines criteria. Overall, patients meeting hospital-based trauma center need was 33.8% compared to 28.4% which met ISS-based trauma center need. Field Triage Guidelines criteria demonstrated a sensitivity of 97.3% and specificity of 13.3% with respect to hospital-based trauma center need with an area under the ROC of 0.80. Mental status and vital signs showed the highest association with trauma center need.

conclusionThe updated 2021 Field Triage Guidelines demonstrate good accuracy when assessed retrospectively on a cohort of patients transferred to a level 1 trauma center. The very high sensitivity of the new guidelines may help to reduce undertriage rates to the international goal of <5%. New criteria in this iteration of the Field Triage Guidelines could lead to improved rates of undertriage specifically in severely injured geriatric patients.

Indexed as

Emergency medical servicesField trauma triageInjury severity scorePrehospital careTrauma

Identifiers

PMID42848131

What OpenQuestion holds

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Registered trials

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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.