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January 23, 1987

The Trauma Score as a Triage Tool

Author Affiliations

University of Wisconsin Hospital and Clinics Madison

University of Wisconsin Hospital and Clinics Madison

JAMA. 1987;257(4):484-485. doi:10.1001/jama.1987.03390040100015

To the Editor.—  The study by Morris et al1 on correlation of the field Trauma Score (TS1) with the Injury Severity Score (ISS) has important implications for appropriate triage of patients to regional trauma centers. These authors are correct in pointing out that it is most important to minimize false-negative assessments despite the unavoidable increase in false-positives. The addition of the diagnosis of penetrating torso trauma as an absolute criterion for transport to a trauma center would have decreased the number of false-negatives from 66 to 55 and increased the false-positives from 107 to 206 (rather than 260, as stated by the authors). This would have had the effect of increasing sensitivity from 63.3% to 69.0% and decreasing specificity from 88.4% to 77.6%.The postassessment probability of severe trauma (ISS≥20) following a negative field assessment (TS1>14) is given by the ratio of false-negatives to all negatives.2