Do the American College of Surgeons “major resuscitation” trauma triage criteria predict emergency operative management?
STUDY OBJECTIVE: We wish to assess whether individual or collective American College of Surgeons’ “major resuscitation” criteria accurately identify injured patients who receive emergency operative treatment. METHODS: In this observational secondary registry analysis of 8,289 consecutive trauma team activations during a 7.5-year period, we evaluated the test performance of 5 American College of Surgeons’ major criteria in predicting emergency (within 1 hour) operative management by general (for adults) or pediatric (for children) surgeons. RESULTS: In adults, the individual major resuscitation criteria each predicted emergency operative management as follows (sorted from highest to lowest test performance): gunshot wounds to the neck or torso (likelihood ratio positive [LR+] 7.5; 95% confidence interval [CI] 6.2 to 9.1); confirmed hypotension (LR+ 5.3; 95% CI 4.0 to 7.1); interhospital transfers requiring blood transfusions (LR+ 4.6; 95% CI 2.6 to 8.2); respiratory compromise (LR+ 2.9;
