Criteria for level 1 and level 2 trauma codes: Are pelvic ring injuries undertriaged?

Brittany E. Haws, Scott Wuertzer, Laura Raffield, Leon Lenchik, Anna N. Miller

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

AIM: To determine the association of unstable pelvic ring injuries with trauma code status. METHODS: A retrospective review of all pelvic ring injuries at a single academic center from July 2010 to June 2013 was performed. The trauma registry was used to identify level 1 and level 2 trauma codes for each injury. The computed tomography scans in all patients were classified as stable or unstable using the Abbreviated Injury Scale. Pelvic injury classifications in level 1 and level 2 groups were compared. Patient disposition at discharge in level 1 and level 2 groups were also compared. RESULTS: There were 108 level 1 and 130 level 2 blunt trauma admissions. In the level 1 group, 67% of pelvic injuries were classified as stable fracture patterns and 33% were classified as unstable. In the level 2 group, 62% of pelvic injuries were classified as stable fracture patterns and 38% were classified as unstable. level 1 trauma code was not associated with odds of having an unstable fracture pattern (OR = 0.83, 95%CI: 0.48-1.41, P = 0.485). In the level 1 group with unstable pelvic injuries, 33% were discharged to home, 36% to a rehabilitation facility, and 32% died. In the level 2 group with unstable pelvic injuries, 65% were discharged to home, 31% to a rehabilitation facility, and 4% died. For those with unstable pelvic fractures (n = 85), assignment of a level 2 trauma code was associated with reduced odds of death (OR = 0.07, 95%CI: 0.01-0.35, P = 0.001) as compared to being discharged to home. CONCLUSION: Trauma code level assignment is not correlated with severity of pelvic injury. Because an unstable pelvis can lead to hemodynamic instability, these injuries may be undertriaged.

Original languageEnglish
Pages (from-to)481-486
Number of pages6
JournalWorld Journal of Orthopaedics
Volume7
Issue number8
DOIs
StatePublished - Aug 18 2016
Externally publishedYes

Keywords

  • Abbreviated injury scale
  • Pelvic ring
  • Trauma code
  • Triage
  • Unstable pelvis

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