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All about the Benjamins: Efficacy of a modified triage protocol for trauma activation in geriatric patients

Published:November 15, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.11.010

      Highlights

      • Using a threshold of SBP <100 mmHg for TTA criteria is safe in geriatric trauma patients.
      • Trauma activation thresholds of SBP <100 mmHg and SBP <110 mmHg have similar under-triage rates.
      • A SBP <110 mmHg threshold is associated with a higher rate of over-triage.

      Abstract

      Background

      The geriatric triage protocol at the study institution was modified from SBP <90 mmHg to SBP <110 mmHg and then to SBP <100 mmHg. The purpose of this study is to evaluate the impact of adjusting geriatric triage protocols on patient outcomes.

      Methods

      A single-center retrospective review was conducted on trauma patients 65 years or older. Three study periods with different geriatric specific trauma team activation (TTA) protocols (Group 1-SBP<90 mmHg; Group 2-SBP<110 mmHg; Group 3-SBP<100 mmHg) were compared.

      Results

      2016 patients were included. There were no differences in mortality rates or need for trauma intervention (NFTI) rates among the three groups. The SBP <100 mmHg and SBP <110 mmHg groups had similar under-triage rates. The NFTI over-triage rate in the SBP <100 mmHg group was lower than the SBP <110 mmHg group.

      Conclusion

      Using SBP <100 mmHg threshold for TTA criteria in geriatric trauma patients improves over-triage without leading to under-triage.

      Keywords

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