Value of triage early warning score for trauma patients in an emergency department

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2015 May;40(5):549-57. doi: 10.11817/j.issn.1672-7347.2015.05.016.

Abstract

Objective: To evaluate the predictive accuracy of the triage early warning score (TEWS) in the prognosis and emergency treatment for trauma patients admitted to the emergency department (ED).

Methods: A total of 456 trauma patients (>12 years old) admitted to ED at an education and research hospital in approximately 4 months were prospectively studied. Th e TEWS was recorded in all patients. Th e primary end-point was during 28 days and the emergency responses (such as cardiopulmonary resuscitation/electrical defibrillation, mechanical ventilation) in the ED.

Results: Patients with TEWS less than or equal to 9, from 10 to 13, or greater or equal to 14 had mortality rates of 0.98%, 52.63%, or 80%, respectively. An increase in 1 point within the range of 17-point TEWS would be associated with an odds ratio (OR) of 2.14 for death [95% confidence interval (CI): 1.759 to 2.604]. In predicting mortality rates during 28 days, the cut-point was greater than 8, the sensitivity was 87.10% (95% CI: 70.2% to 96.4%), the specificity was 92.47% (95% CI: 89.5% to 94.8%), and the areas under the receiver operating characteristic curves (AUCROC) was 0.929 (95% CI: 0.902 to 0.951). Th e AUCROC of TEWS in predicting the emergency responses for CPR/electrical defibrillation application or mechanical ventilation was 0.969 (95% CI: 0.949 to 0.983) or 0.897 (95% CI: 0.865 to 0.923), respectively.

Conclusion: TEWS is effective in predicting the prognosis and emergency treatment for trauma patients admitted to ED.

MeSH terms

  • Area Under Curve
  • Emergency Service, Hospital / organization & administration*
  • Hospitalization
  • Humans
  • Prognosis
  • Prospective Studies
  • ROC Curve
  • Sensitivity and Specificity
  • Triage / methods*
  • Wounds and Injuries / diagnosis*