[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    Views 637
    Citations 0
    Research Letter
    August 7, 2019

    Efficacy of Prehospital Criteria in Identifying Trauma Patients Susceptible to Undertriage

    Author Affiliations
    • 1Department of Surgery, Oregon Health & Science University, Portland
    JAMA Surg. 2019;154(10):973-974. doi:10.1001/jamasurg.2019.2497

    Earlier recognition of severe traumatic injury and triage to the proper trauma level designation are essential factors in the safe and effective care of trauma patients.1 Trauma-level activation often dictates the personnel present at the initial trauma resuscitation, and undertriage has been associated with worse clinical outcomes.2

    Traditionally, undertriage has been evaluated using the Injury Severity Score. The problem with using this approach to evaluate triage-level appropriateness is that the Injury Severity Score is determined either at the time of discharge or death and therefore cannot prospectively identify patients who were undertriaged.

    After a review of 10 years (2004-2014) of data on adult trauma activations at a single institution, tachypnea (respiratory rate, >22 breaths per minute) and blunt thoracic injury were associated with undertriage and were added to higher-level trauma activation criteria at the institution.3 In this study, we sought to determine if other clinically relevant prehospital criteria could be used to accurately identify patients who are more likely to be undertriaged.