Effectiveness of Simple Trauma Team Activation Criteria on Prognosis of Severe Trauma Patients

Lee, Dong Keon; Lee, Kang Hyun; Cha, Kyoung Chul; Park, Kyoung Hye; Choi, Han Joo; Kim, Hyun; Hwang, Sung Oh

Abstract

PURPOSE
The goal of this study was to compare the outcome of the after trauma team (AfterTT) group to the before trauma team (BeforeTT) group.
METHODS
All trauma patients who visited to emergency room (ER) between July 1, 2006 and February 29, 2008 based on trauma registry, with systolic blood pressure (SBP) < 90 mmHg or GCS < 9 were included in this study. We compared the amount of packed RBC transfusion, the ER stay time, the ER visit to CT evaluation time, the ER visit to operation time, the length of ICU stay, the length of hospital admission and the survival discharge rate between the AfterTT group and the BeforeTT group. Patients with brain injuries had little chance of survival. Burn patients, who visited the ER 24 hours after injury and patients who were dead on arrival (DOA) were excluded from this study.
RESULTS
Total of 93 patients were included in this study: 42 in the AfterTT group and 51 in the BeforeTT group. The AfterTT group and the Before TT group showed no differences in Revised Trauma Score (RTS) and mean age. The amount of packed RBC transfusion was lower in the AfterTT group, but no statistically significant difference was noted (AfterTT 11+/-11units, BeforeTT 16+/-15units, p=0.136). The ER visit to operation time was shorter in the AfterTT group, but there were no statistically significant difference between the groups (AfterTT 251+/-223 minutes, BeforeTT 486+/-460 minutes, p=0.082). The length of ICU stay was shorter in the AfterTT group, but the difference was not statistically significant (AfterTT 11+/-12 days, Before TT 15+/-30 days, p=0.438). The length of Hospital admission was shorter in the AfterTT group (AfterTT 43+/-37 days, BeforeTT 68+/-70 days, p=0.032), but this difference was not statistically significant.
CONCLUSION
Simple Trauma team activation criteria decreased the amount of packed RBC transfusion and the hospital admission duration. Hemodynamic instability (SBP < 90 mmHg) and decreased mental state (GCS <9) are good indices for activating the trauma team.