Assessment of the correlation between the Vittel criteria and the ISS score: A novel approach to pre-hospital severe trauma patient's triage.
La Tunisie medicale · 2024-12-05 · Observational study
Abstract
UNLABELLED: Introduction-Aim: Validated triage tools such as the Vittel criteria are essential to improve the care of trauma patients. The aim of this study was to evaluate the correlation between the Vittel triage criteria and the Injury Severity Score (ISS) to improve the accuracy of pre-hospital triage. METHODS: We conducted a longitudinal study of all trauma patients transported by EMS over a two-year period (November 2021- November 2023). Vittel and (ISS) scores were calculated on admission. Predictive Vittel criteria were defined by independent risk factors for ISS>15 using a multiple logistic regression model with p-value < 0.05 and/or sensitivity (se)>50%, with positive Youden index (Yi). RESULTS: A total of 461 trauma patients were transported by EMS during the study period were included. The sex ratio was 5.3 and road traffic accidents accounted for 77.2%. An ISS>15 was found in 41% of participants, 25% required ICU admission and 23.9% died within 30 days. Using the above selection criteria, we identified seven key predictive criteria (OR CI 95%, se%, Yi) Glasgow coma scale<13(3.16 [1.91 5.24],44,0.25); fall>6 m(4.031[1.61-10.08],10,0.07); severe burn(23.89[10.21-55.93],6,0.02); Pelvic fracture (4.93 [1.19-20.32], 28, 0.25),suspected spinal cord injury(6.89 [2.79-16.96], 6, 0.05); Fluid resuscitation>1000 ml(-, 60.0. 11); Catecholamine (2.02 [1.09-3.75],51.0.27). Physiological variables (se 30%, Yi 0.16) and pre-hospital resuscitation(se 46%, Yi 0.18) were among the most relevant categories for predicting severity, similar to the full Vittel score. CONCLUSION: Seven criteria were associated with severe trauma (ISS score >15). Physiological variables and pre-hospital resuscitation were significant categories that may help to predict the severity of trauma and its impact on patients.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Mortality & survival · Triage instruments
Related articles
- Pediatric trauma triage: A Pediatric Trauma Society Research Committee systematic review. (J Trauma Acute Care Surg, 2020)
- Which pre-hospital triage parameters indicate a need for immediate evaluation and treatment of severely injured patients in the resuscitation area? (Eur J Trauma Emerg Surg, 2019)
- Precision of field triage in patients brought to a trauma centre after introducing trauma team activation guidelines. (Scand J Trauma Resusc Emerg Med, 2009)
- A prehospital glasgow coma scale score < or = 14 accurately predicts the need for full trauma team activation and patient hospitalization after motor vehicle collisions. (J Trauma, 2002)
- Patient Outcomes Based on the 2011 CDC Guidelines for Field Triage of Injured Patients. (J Trauma Nurs, 2023)
- Predicting 2-day mortality in the pre-hospital setting: A retrospective cohort study comparing the New Zealand Early Warning Score (NZEWS) and paramedic triage Status Codes (Paramedicine, 2026)