We used Level I trauma center registry data from September 1, 1995, through November 30, 2008. Outcomes were confirmed with blinded abstractors. Sensitivity, specificity, and 95 % confidence intervals (CIs) were calculated.
Our patient sample included 20,872 individuals. The median Injury Severity Score was 9 (interquartile range 4 to 16), 15.3 % of patients had penetrating injuries, 13.5 % had a systolic blood pressure less than 100 mm Hg, and 32.5 % had a pulse rate greater than 100 beats/min. Emergency operative intervention or procedural intervention was required in 1,099 patients (5.3 % ; 95 % CI 5.0 % to 5.6 % ). The sensitivities and specificities of the rule and the major resuscitation criteria for predicting emergency operative intervention or emergency procedural intervention were 95.6 % (95 % CI 94.3 % to 96.8 % ) and 56.1 % (95 % CI 55.4 % to 56.8 % ) and 85.5 % (95 % CI 83.3 % to 87.5 % ) and 80.9 % (95 % CI 80.3 % to 81.4 % ), respectively.
This new rule was more sensitive for predicting the need for emergency operative intervention or emergency procedural intervention directly compared with the American College of Surgeons' major resuscitation criteria, which may improve the effectiveness and efficiency of trauma triage.