Field trauma triage: combining mechanism of injury with the prehospital index for an improved trauma triage tool

J Trauma. 1997 Aug;43(2):283-7. doi: 10.1097/00005373-199708000-00013.


Background: The objective of this study was to combine a physiologic triage score (prehospital index, PHI) with criteria regarding mechanism of injury (MOI) to increase the efficacy of trauma triage. The specific question being asked was: will the combined score improve the sensitivity and specificity over that of the individual scores?

Methods: In this prospective study, 3,147 injury patients (all adults > or = 14 years) were reviewed. Each patient received a PHI score and a MOI score in the field, which were compared with their Injury Severity Score (ISS) at separation. An ISS > or = 16 was defined as major trauma.

Results: PHI alone had a sensitivity of 41%, MOI alone had a sensitivity of 73%, whereas the combined PHI/MOI score had a sensitivity of 78%. All three had similar specificities. These findings were statistically significant (p < or = 0.001).

Conclusion: The combined PHI/MOI score was better at identifying those patients with ISS scores > or = 16 compared with the PHI and MOI scores alone. Although this permitted superior triage (and minimized overtriage), the combined score did not identify all major trauma patients.

Publication types

  • Comparative Study

MeSH terms

  • Accidents
  • Adolescent
  • Adult
  • Emergency Medical Services*
  • Humans
  • Injury Severity Score*
  • Prospective Studies
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Sports
  • Triage / methods*
  • Triage / standards
  • Violence
  • Wounds and Injuries / classification*
  • Wounds and Injuries / diagnosis
  • Wounds and Injuries / etiology