Triage criteria for trauma centers and in-hospital mortality of victims of external causes: a Brazilian cohort.
Ciencia & saude coletiva · 2025-07-23 · Observational study
Abstract
This study aimed to associate the triage criteria of the American College of Surgeons Committee on Trauma (ACS-COT) with hospital mortality among Brazilian trauma patients. A prospective cohort study was conducted in 2019 at 10 Brazilian institutions, involving trauma patients aged 18 or older who received prehospital care at the trauma scene. The 11 ACS-COT criteria were the independent variables, and the hospital clinical outcome (discharge or death) was the dependent variable. The Pearson's Chi-Square and Fisher's Exact tests and the Odds Ratio (OR) calculation were applied with a significance level of 5%. Of the 626 trauma patients, 54.95% were screened incorrectly. There were significant differences between the groups (hospital discharge or death) in 7 of the 11 ACS-COT criteria. The criteria with the highest odds for hospital death were systolic blood pressure less than 90 mmHg (OR 82.50), Glasgow Coma Scale equal to or less than 13 (OR 52.87), and respiratory rate less than 10 or greater than 29 breaths per minute (bpm) or the need for ventilatory support (OR 32.35). Altered vital signs at the trauma scene were conditions with the highest likelihood of hospital death, highlighting the importance of applying triage criteria for the correct referral of trauma patients to healthcare services.