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Factors Associated with Secondary Overtriage in Renal Trauma
Journal article   Peer reviewed

Factors Associated with Secondary Overtriage in Renal Trauma

Judith C Hagedorn, Duane A Quistberg, Saman Arbabi, Hunter Wessells and Monica S Vavilala
Urology (Ridgewood, N.J.), v 130
Aug 2019
DOI: https://doi.org/10.1016/j.urology.2019.02.046
PMID: 31029673
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Adolescent Adult Aged Aged, 80 and over Child Child, Preschool Female Humans Infant Injury Severity Score Kidney - injuries Male Middle Aged Patient Transfer - statistics & numerical data Triage - statistics & numerical data Young Adult
To examine secondary overtriage for isolated renal trauma patients and to use secondary overtriage criteria to determine factors associated with unnecessary interhospital transfers in patients with isolated renal trauma. The National Trauma Data Bank was used to identify isolated renal trauma patients of any age who were transferred to a level I or II trauma center from 2007 to 2014. Secondary overtriage criteria were defined as hospital length of stay <72 hours, no ICU admission, no emergent transfer from the ED to the OR, no operating room procedure, and no renal IR/OR procedure. Adjusted risk ratios (RR) and 95% confidence intervals were estimated using Poisson regression. A total of 8156 isolated renal injury patients who were transferred to either a level I or II trauma center were identified. More than half (53%) of the transferred patients had low-grade renal injuries (American Association for the Surgery of Trauma (AAST) Grade I/II). Our definition of secondary overtriage was met in 3005 patients (37%). In this group, 59% had low-grade renal injuries. The risk of being overtriaged was significantly reduced with increasing renal injury grade, hypotension in the emergency department, firearm injuries, older age (>65 years), medicare payer status, and any substance abuse. Secondary overtriage is common in isolated renal trauma. Factors associated with secondary overtriage are age ≤65 years, falls, and low renal injury grade. The high rate of unnecessary transfers shows that there is a need for disease-specific transfer guidelines to assure safe, cost-effective, and efficient health care in isolated renal trauma.

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8 citations in Web of Science
9 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Urology & Nephrology
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