dc.contributor.author | Thorsen, Kenneth | |
dc.contributor.author | Narvestad, Jon | |
dc.contributor.author | Tjosevik, Kjell Egil | |
dc.contributor.author | Larsen, Johannes Wiik | |
dc.contributor.author | Søreide, Kjetil | |
dc.date.accessioned | 2021-11-12T14:29:25Z | |
dc.date.available | 2021-11-12T14:29:25Z | |
dc.date.created | 2021-07-16T15:27:37Z | |
dc.date.issued | 2021 | |
dc.identifier.issn | 1863-9933 | |
dc.identifier.uri | https://hdl.handle.net/11250/2829406 | |
dc.description.abstract | Background: The aim of this study was to compare the effect of the change in TTA protocol from a two-tier to one-tier, with focus on undertriage and mortality.
Material and methods: A before–after observational cohort study based on data extracted from the Stavanger University Hospital Trauma registry in the transition period from two-tier to a one-tier TTA protocol over two consecutive 1-year periods (2017–2018). Comparative analysis was done between the two time-periods for descriptive characteristics and outcomes. The main outcomes of interest were undertriage and mortality.
Results: During the study period 1234 patients were included in the registry, of which 721 (58%) were in the two-tier and 513 (42%) in the one-tier group. About one in five patients (224/1234) were severely injured (ISS > 15).
Median age was 39 in the two-tier period and 43 years in the one-tier period (p = 0.229). Median ISS was 5 for the two-tier period vs 9, in the one-tier period (p = 0.001). The undertriage of severely injured patients in the two-tier period was 18/122 (15%), compared to 31/102 (30%) of patients in the one-tier period (OR = 2.5; 95% CI 1.8–4.52). Overall mortality increased significantly between the two TTA protocols, from 2.5 to 4.7% (p = 0.033), OR 0.51 (0.28–0.96)
Conclusion: A protocol change from two-tiered TTA to one-tiered TTA increased the undertriage in our trauma system. A two-tiered TTA may be beneficial for better patient care. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Springer | en_US |
dc.rights | Navngivelse 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/deed.no | * |
dc.title | Changing from a two-tiered to a one-tiered trauma team activation protocol: a before–after observational cohort study investigating the clinical impact of undertriage | en_US |
dc.type | Journal article | en_US |
dc.type | Peer reviewed | en_US |
dc.description.version | publishedVersion | en_US |
dc.rights.holder | Copyright 2021 the authors | en_US |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |
dc.identifier.doi | 10.1007/s00068-021-01696-y | |
dc.identifier.cristin | 1921955 | |
dc.source.journal | European Journal of Trauma and Emergency Surgery | en_US |
dc.identifier.citation | European Journal of Trauma and Emergency Surgery. 2021. | en_US |