0242/2025 - Critérios de triagem para centros de trauma e mortalidade hospitalar de vítimas de causas externas: uma coorte brasileira Triage criteria for trauma centers and in-hospital mortality of victims of external causes: a Brazilian cohort
O objetivo foi associar os critérios de triagem do American College Surgeons Committee on Trauma (ACS-COT) com a mortalidade hospitalar de traumatizados no Brasil. Coorte prospectiva realizada no ano de 2019 em 10 instituições brasileiras, com traumatizados de 18 anos ou mais que receberam atendimento pré-hospitalar na cena do trauma. Os 11 critérios do ACS-COT foram as variáveis independentes e o desfecho clínico hospitalar (alta ou óbito) foi a variável dependente. Os testes Qui-Quadrado de Pearson e Exato de Fisher e o cálculo do Odds Ratio (OR) foram aplicados com nível de significância de 5%. Dos 626 traumatizados, 54,95% foram triados incorretamente. Houve diferenças significativas entre os grupos (alta ou óbito hospitalar) em 7 dos 11 critérios do ACS-COT. Os critérios com maiores chances para óbito hospitalar foram pressão arterial sistólica inferior a 90 mmHg (OR 82,50), Glasgow menor ou igual a 13 (OR 52,87) e frequência respiratória menor que 10 ou maior que 29 incursões por minuto ou necessidade de suporte ventilatório (OR 32,35). Sinais vitais alterados na cena do trauma foram condições com maior chance de óbito hospitalar, evidenciando a importância da aplicação dos critérios de triagem para o encaminhamento correto do traumatizado ao serviço de saúde.
Palavras-chave:
Triagem. Causas externas. Emergências. Ferimentos e lesões. Mortalidade hospitalar.
Abstract:
The aim was to associate the triage criteria of the American College Surgeons Committee on Trauma (ACS-COT) with hospital mortality among trauma patients in Brazil. A prospective cohort study was conducted in 2019 at 10 Brazilian institutions, involving trauma patients aged 18 or older who received pre-hospital care at the trauma scene. The 11 ACS-COT criteria were the independent variables, and the hospital clinical outcome (discharge or death) was the dependent variable. The Pearson’s Chi-Square and Fisher’s Exact tests and the Odds Ratio (OR) calculation were applied with significance level of 5%. Of the 626 trauma patients, 54.95% were triaged incorrectly. There were significant differences between the groups (hospital discharge or death) in 7 of the 11 ACS-COT criteria. The criteria with the highest odds for hospital death were systolic blood pressure less than 90 mmHg (OR 82.50), GCS equal to or less than 13 (OR 52.87), and respiratory rate less than 10 or greater than 29 breaths per minute (bpm) or the need for ventilatory support (OR 32.35). Altered vital signs at the trauma scene were conditions with the highest chance of hospital death, highlighting the importance of applying triage criteria for the correct referral of trauma patients to healthcare services.
Keywords:
Triage. External causes. Emergencies. Injuries and wounds. Hospital mortality.
Triage criteria for trauma centers and in-hospital mortality of victims of external causes: a Brazilian cohort
Resumo (abstract):
The aim was to associate the triage criteria of the American College Surgeons Committee on Trauma (ACS-COT) with hospital mortality among trauma patients in Brazil. A prospective cohort study was conducted in 2019 at 10 Brazilian institutions, involving trauma patients aged 18 or older who received pre-hospital care at the trauma scene. The 11 ACS-COT criteria were the independent variables, and the hospital clinical outcome (discharge or death) was the dependent variable. The Pearson’s Chi-Square and Fisher’s Exact tests and the Odds Ratio (OR) calculation were applied with significance level of 5%. Of the 626 trauma patients, 54.95% were triaged incorrectly. There were significant differences between the groups (hospital discharge or death) in 7 of the 11 ACS-COT criteria. The criteria with the highest odds for hospital death were systolic blood pressure less than 90 mmHg (OR 82.50), GCS equal to or less than 13 (OR 52.87), and respiratory rate less than 10 or greater than 29 breaths per minute (bpm) or the need for ventilatory support (OR 32.35). Altered vital signs at the trauma scene were conditions with the highest chance of hospital death, highlighting the importance of applying triage criteria for the correct referral of trauma patients to healthcare services.
Palavras-chave (keywords):
Triage. External causes. Emergencies. Injuries and wounds. Hospital mortality.
Vieira, RCA, Sousa, RMC, Domingues, CA, Fernandes, LC, Sloboda, DA, Oberg, LMCQ, Nacer, DT, Belo, FL, Martins, EAP, Santana-Santos, E, Nogueira, LS. Critérios de triagem para centros de trauma e mortalidade hospitalar de vítimas de causas externas: uma coorte brasileira. Cien Saude Colet [periódico na internet] (2025/jul). [Citado em 05/12/2025].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/criterios-de-triagem-para-centros-de-trauma-e-mortalidade-hospitalar-de-vitimas-de-causas-externas-uma-coorte-brasileira/19718
