Optimizing Trauma Activation Criteria for a Rural Trauma Center

Abstract

BACKGROUND: There is a need for activation criteria that reflect the different factors affecting rural trauma patients. OBJECTIVE: To develop effective activation criteria for a rural trauma center among adults, incorporating variables specific to the geography, mechanisms of injury, and population served. METHODS: This is a single-center, retrospective cohort study conducted from (23 years) January 1, 2000, to July 31, 2023. The data collected patient demographics, injury details, morbidity, and preexisting comorbidity. This research included all adult (≥15 years) true Level I trauma activations defined as an injury severity score > 25 and met the need for trauma intervention criteria. The patients were grouped into adult and elderly categories. The analysis utilized a logistic regression model with the outcome of a true Level I trauma activation. RESULTS: A total of 19,480 patients were included in the sample; 2,858 (14.6%) met the Level I activation criteria. Elderly Level I activation included assault, pedestrian struck, multiple pelvic fractures, traumatic pneumo/hemothorax, mediastinal fracture, sternum fracture, and flail rib fracture. CONCLUSION: Using the findings of the logistic regression model, this center has made more robust activation guidelines adapted to its rural population.