TY - JOUR
T1 - External signs of trauma
T2 - A poor predictor of injury in found down and ground level falls
AU - Foster, Shannon Marie
AU - Muller, Alison
AU - Jones, Pamela
AU - Engle, Laura
AU - Sherwood, Alicia
AU - Geng, Thomas A.
AU - Ong, Adrian W.
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/11
Y1 - 2020/11
N2 - Background: The significance of external signs (EST) and signs or symptoms of trauma (SS) after ground level falls or found down (GLF/FD) is unclear. We hypothesized that EST and SS were associated with injury. Methods: Patients with GLF/FD were retrospectively studied. SS was defined as having any EST, tenderness, or subjective complaint. Outcomes were any significant finding (SF) and Injury Severity Score (ISS) > 8. Diagnostic accuracy of EST and SS were assessed with positive and negative likelihood ratios (LR+, LR-). Results: Of 578 patients, 66% and 95% had EST and SS respectively. For EST, LR+ and LR-were 1.14 and 0.76 (SF), and 1.21 and 0.64 (ISS>8). For SS, LR+ and LR-were 1.07 and 0.19 (SF), and 1.03 and 0.49 (ISS>8). Conclusion: EST lacked sufficient diagnostic accuracy for SF and ISS>8. Lack of SS was reasonably accurate in ruling out SF but not ISS>8. Triage utilizing EST alone for GLF/FD is not useful.
AB - Background: The significance of external signs (EST) and signs or symptoms of trauma (SS) after ground level falls or found down (GLF/FD) is unclear. We hypothesized that EST and SS were associated with injury. Methods: Patients with GLF/FD were retrospectively studied. SS was defined as having any EST, tenderness, or subjective complaint. Outcomes were any significant finding (SF) and Injury Severity Score (ISS) > 8. Diagnostic accuracy of EST and SS were assessed with positive and negative likelihood ratios (LR+, LR-). Results: Of 578 patients, 66% and 95% had EST and SS respectively. For EST, LR+ and LR-were 1.14 and 0.76 (SF), and 1.21 and 0.64 (ISS>8). For SS, LR+ and LR-were 1.07 and 0.19 (SF), and 1.03 and 0.49 (ISS>8). Conclusion: EST lacked sufficient diagnostic accuracy for SF and ISS>8. Lack of SS was reasonably accurate in ruling out SF but not ISS>8. Triage utilizing EST alone for GLF/FD is not useful.
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U2 - 10.1016/j.amjsurg.2020.06.046
DO - 10.1016/j.amjsurg.2020.06.046
M3 - Article
C2 - 32650978
AN - SCOPUS:85087664752
SN - 0002-9610
VL - 220
SP - 1300
EP - 1303
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 5
ER -