Assessment of the Suitability of Trauma Triage According to Physiological Criteria in Korea

Purpose: A trauma center project for treating patients with trauma has been established in Korea. A trauma team is activated based on the Centers for Disease Control and Prevention (CDC) field triage Step 1 for patient triage. Here, we determined if the currently applied criteria were appropriate for the triage of patients with trauma in Korea.Methods: This retrospective study included patients who were taken to the regional trauma center from January 1, 2016 to December 31, 2019, and were registered in the Korean Trauma database. The rates for undertriage and overtriage were calculated from the in-field and in-hospital triage according to the CDC guidelines Step 1.Results: Among the 9,383 patients transferred to the trauma center, 3,423 were directly transferred from the site and were investigated. The overall rates for undertriage and overtriage of these patients were 28.13% and 30.35%, respectively. For the patients who received in-field triage and were directly transferred to the trauma center, the rates for undertriage and overtriage were 27.92% and 32.39%, and 25.92% and 29.11% for in-hospital triage, respectively. The concordance rate of triage was 87.09%.Conclusion: The current use of in-hospital triage physiological criteria as set out in the CDC guidelines Step 1, indicated an undertriage rate which was high and an overtriage rate within the acceptable range. Further studies on triaging patients with trauma are warranted. Improvements in the guidelines of the trauma center project are necessary and this needs to be supported by resources and training for field personnel.