Development and Evaluation of a Triage Index for Penetrating Trauma

Abstract : Several new severity scores, the Triage Score, the Triage Index, and Trauma Score, were evaluated for patients with penetrating injuries. The scores, are composed of measures easily obtained by either medical or paramedical personnel using noninvasive techniques and without resorting to instrumentation. The data for the study were obtained from a series of 864 consecutive patients treated at the Washington Hospital Center for penetrating injuries. The data consisted of outcome information (survivor or non-survivor) and coded hospital admission values of seven variables: respiratory expansion, capillary refill, eye opening, best verbal response to stimulus, best motor response to stimulus, respiratory rate, and systolic blood pressure. The Triage Score and Triage Index are functions of the first 5 variables in the list, while the Trauma Score depends on all 7 variables. Probability of survival estimates for the Triage Score, Triage Index, and Trauma Score were obtained using a logistic function method. The predictive 'power' of each of the severity measures was computed for the penetrating injury data. All three measures were extremely powerful predictors of mortality for this data set. Probability of survival estimates were also obtained for the Trauma Score and Triage Score for combined penetrating and blunt injury data. We believe that the Triage Score or Trauma Score could be incorporated into military triage rationales at several echelons of care.