Newgard et al studied field triage of elderly patients with trauma. The use of additional factors can improve sensitivity but with a loss of specificity. The authors are from Oregon Health & Science University and University of Washington in Seattle.

Patient selection: injured patient >= 65 years of age


Outcome: ISS >= 16 or need for major non-orthopedic surgery


Standard field triage criteria (detects only about a third of patients with outcome)

(1) ISS >= 16

(2) major non-orthopedic surgery required

(3) head AIS >= 3

(4) chest AIS >= 3

(5) abdominopelvic AIS >= 3


Glasgow coma scale and vital signs (Newgard, 2014)

(1) GCS <= 14

(2) systolic blood pressure <= 110 or >= 200 mm Hg

(3) breathing rate <= 10 or >= 24 breaths per minute

(4) heart rate <= 60 or >= 110 beats per minute


Additional findings:

(1) comorbidities from the Charlson comorbidity index >= 2 (myocardial infarction, ulcer, cancer, congestive heart failure, stroke, dementia, diabetes, hepatic failure, paralysis, pulmonary dysfunction, renal insufficiency, rheumatic arthritis (connective tissue disease), vascular disease)


If 1 or more of these findings are present, then the patient is considered high risk.


Oral anticoagulant use could be used in place of comorbidities.

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