Application to a Taiwan Population of the Modified Prehospital Trauma Triage Criteria of the American College of Surgeons Committee on Trauma

運用美國外傷學院之嚴重外傷判斷準則之修改版於臺灣病人

林朝順(Chaou-Shune Lin) ； 劉正耀(Cheng-Yao Liu) ； 謝國雄(Kou-Shiong Hsieh) ； 王玉璋(Yu-Chang Wang) ； 張玉龍(Yu-Long Chang)

《Journal of Emergency Medicine, Taiwan》 6卷2期 (2004/06) Pp. 288-296

摘要

目的：檢驗美國外傷學院之重大外傷判斷準則之修訂版，在辨認外傷病人轉送創傷中心之敏感性與特異性。
方法： 在2001年12月至2002年5月，緊急救護員依據重大外傷判斷準則修訂版的12個變數，判斷病人是否為重大外傷。而病人若符合下列條件，則表示需要轉送外傷中心：1)到院後72小時內死亡；2)到院後24小時內因頭部外傷而住進加護病房；3)到院後4小時接受非骨科之緊急手術。重大外傷判斷準則修訂版之判斷能力是藉由比較緊急救護員依據重大外傷判斷準則的判斷結果與符合外傷中心轉送條件的結果而計算出其敏感性與特異性。
結果： 在2565位病人中，有125位(4.9%)符合轉送外傷中心。重大外傷判斷準則之敏感性82%(95% CI；75.3%~88.7%)，特異性98.2%(95% CI；97.7%~98.7%)。
結論： 修正版之重大外傷判斷準則可適用在台灣之創傷病人

關鍵字

創傷系統 ； 緊急醫療網 ； 外傷中心

並列摘要

Objective: To prospectively determine the ability of a modification of the trauma triage criteria (MTTC) of the American College of Surgeons to identify patients who need trauma center referral in a prehospital setting.
Methods: Emergency Medical Technicians (EMTs) identified all 12 MTTC variables applicable to the trauma victims delivered to three hospitals in the study site between October 2001 and May 2002. Trauma center need was defined as the occurrence of either death within 72 hours, admission to the ICU for monitoring of closed-head injuries within 24 hours, or a non-orthopedic major operation within 4 hours of hospital arrival. The diagnostic performance was determined by comparing the EMTs’ judgment using the MTTC with whether patients actually needed trauma center referral.
Results: Of the 2565 patients included in the statistical analysis, 125 (4.9%) required trauma center management. The MTTC had a sensitivity of 82% (95% CI; 75.3%–88.7%) and a specificity of 98.2% (95% CI; 97.7%–98.7%) in predicting trauma center need.
Conclusion: The MTTC were appropriate when applied to Taiwanese trauma patients.

並列關鍵字

EMS systems ； trauma triage ； trauma care systems