Vittel criteria for severe trauma triage: Characteristics of over-triage - 07/06/16
, Fredrik Courjon b , Sébastien Beaume b , Bertrand Prunet a , Julien Bordes a , Cédric N’Guyen a , Claire Contargyris a , Guillaume Lacroix a , Ambroise Montcriol a , Eric Kaiser a , Eric Meaudre a Bienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Aim |
Over-triage rates related to the use of Vittel criteria are unknown. We compared severe stable trauma patients with and without significant visceral injuries.
Study design |
A single-centre retrospective analysis of a single-centre prospective cohort.
Patients and methods |
Trauma patients with at least one positive Vittel criterion from June 2010 to January 2012 in a level-1 trauma centre. Initial management included a systematic whole-body scanner. All significant lesions in stable trauma patients were recorded.
Results |
A total of 252 trauma patients were admitted. One hundred and twenty were stable. In this group without vital distress, 72 (60%) had at least one occult lesion, 21 (17.5%) had an isolated orthopaedic injury and 27 (22.5%) had no injury. Thoracic injuries accounted for 44% of visceral injuries, abdominal for 17%, spinal for 16% and cerebral for 15%. Overall, the over-triage rate was 19%. Surgery for significant visceral injury was performed in 13 patients (18%) and arteriography in 4 patients (5.5%). Admission in an intensive care unit was required for 13 patients with occult injuries and for one patient without such a lesion (18% versus 2%, P=0.008). Hospital stays were longer in the group with visceral injuries (4±7 versus 9±8days; P=0.006).
Conclusion |
Vittel criteria use in trauma patients induces an acceptable over-triage rate. A large proportion of stable trauma patients have occult lesions. These visceral injuries frequently require special care. These data highlight the imperative need to transport major trauma patients immediately to a dedicated trauma centre and supports whole-body scanner use.
Le texte complet de cet article est disponible en PDF.Keywords : Severe trauma, Vittel criteria, Triage
Plan
Vol 35 - N° 2
P. 87-92 - avril 2016 Retour au numéro
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