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Background <p>With the 2023 revision of the German S3&#xa0;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.</p> Objective <p>The aim of this study was to assess the effects of the guideline update on patient treatment in the emergency department of a&#xa0;level&#xa0;I trauma center.</p> Methods <p>In a&#xa0;prospective, single-center observational study, all patients presenting after motor vehicle accidents were recorded over a&#xa0;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.</p> Results <p>A&#xa0;total of 1438 cases were analyzed. The number of red-triaged patients decreased significantly (257 vs. 157; <i>p</i> &lt; 0.001). The overtriage rate among TTA patients declined (27.6% vs.&#xa0;21%, <i>p</i> &lt; 0.01) without a&#xa0;significant increase in undertriage. Mortality and hospital length of stay did not differ significantly between groups.</p> Conclusion <p>The revision of TTA criteria led to a&#xa0;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.</p>

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Traumateamaktivierung nach Verkehrsunfällen – Auswirkung der Indikationsänderungen in der S3-Leitlinie Polytrauma/Schwerverletzten-Behandlung

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月29日

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  • Bastian Brune,
  • Max Bittner,
  • Fabian Haut,
  • Maximilian Wolf,
  • Sascha Keil,
  • André Nohl,
  • Frank Herbstreit,
  • Christian Waydhas,
  • Lars Becker,
  • Marcel Dudda

摘要

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.