[Trauma team activation following motor vehicle accidents-impact of changes in criteria in the S3 guideline on polytrauma/severely injured patient care].

Abstract

Background: With the 2023 revision of the German S3 guideline "Polytrauma/severely injured patient care" the criteria for trauma team activation (TTA) were revised. Accident mechanism-based criteria were largely eliminated. The impact of these changes on emergency department (ED) management, over- and undertriage following traffic accidents, and hospital length of stay has not yet been systematically evaluated.

Objective: The aim of this study was to assess the effects of the guideline update on patient treatment in the emergency department of a level I trauma center.

Methods: In a prospective, single-center observational study, all patients presenting after motor vehicle accidents were recorded over a 2-year period (pre- vs. postguideline update). Primary endpoints were the frequency and appropriateness of TTA as well as the distribution of treatment locations. Secondary endpoint was hospital length of stay.

Results: A total of 1438 cases were analyzed. The number of red-triaged patients decreased significantly (257 vs. 157; p < 0.001). The overtriage rate among TTA patients declined (27.6% vs. 21%, p < 0.01) without a significant increase in undertriage. Mortality and hospital length of stay did not differ significantly between groups.

Conclusion: The revision of TTA criteria led to a marked reduction in trauma team activations while maintaining quality of care. No significant increase in undertriage was observed. The updated TTA criteria may support resource-efficient patient care without compromising safety.