Implementation of New Trauma Triage Criteria and Implications on Under- and Overtriage.

Completed

• Conditions: Trauma Injury
• Interventions: Diagnostic Test: Implementation of new alert criteria

• Registration Number: NCT03395158
• Lead Sponsor: Uppsala University

Brief Summary

New trauma alert criteria has been introduced in Sweden, and our aim in this study is to evaluate the outcome of the old and new trauma alert criteria in a cohort of 1.300.000 inhabitants at six hospitals regarding over- and undertriage and number of alerts initiated. The Swedish trauma registry is used to identify eligible patients.

Detailed Description

The Swedish trauma registry (SweTrau) was initiated in 2011, and has up to date 40.000 registered patients. In order to evaluate trauma alert criteria implemented during 2017, we plan a prospective stepped wedge trial at six hospitals in the Uppsala/Örebro region. These hospitals register in SweTrau and all had the same alert criteria prior to the implementation of new alert criteria.

A power estimation show the need for 588 patients in each group in order to show a statistical difference between 2-5% undertriage at a 95% CI.

The including hospitals has a population base of 1.300.000 inhabitants, and the annual number of trauma alerts has been about 3.000.

The registry has information about time of trauma, initiated alerts, Injury Severity Score and mechanism of injury suitable for analysis for our hypothesis.

Study Timeline

• Study Start: 2016-06-01
• Primary Completion: 2017-11-01
• Study Completion: 2017-11-01
• Study First Submitted: 2017-12-15
• Status Verified: 2018-01
• Study First Submitted QC: 2018-01-09
• Last Update Submitted: 2018-01-09
• Study First Posted: 2018-01-10
• Last Update Posted: 2018-01-10

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 2200

Inclusion Criteria

• All patients registered in SweTrau at all including sites between 1 June 2016 and 1 November 2017

Exclusion Criteria

• Patients registered due to secondary referral where the initial assessment was performed at another hospital

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Prior alert criteria	Implementation of new alert criteria	Patients who activated full, limited or no alert criteria according to the prior alert criteria
Present alert criteria	Implementation of new alert criteria	Patients who activated full, limited or no alert criteria according to the present alert criteria

Primary Outcome Measures

Name	Time	Method
Number of alerts initiated	One year data with intervention	The total number of trauma alerts initiated in the study group

Secondary Outcome Measures

Name	Time	Method
Analysis of over- and undertriage with the Matrix method	One year data with intervention	Analyse proportions of patients subject to a full trauma team activation who have an injury severity score \<15 (overtriage). Analyse proportion of patients who do not initiate a full trauma team activation but have an injury severity score \>15 (undertriage) The Matrix method is a well defined method for analysing resource allocation in trauma triage.