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. Author manuscript; available in PMC: 2017 Jan 1.
Published in final edited form as: Injury. 2015 Sep 30;47(1):19–25. doi: 10.1016/j.injury.2015.09.010

Figure 2.

Figure 2

Alternative out-of-hospital method for identifying older adults with Injury Severity Score ≥ 16 (validation sample n = 13,401).

*Including high-risk mechanism (fall, motor vehicle occupant, auto vs. pedestrian/bicycle, significant medical illness, or suffocation) as a separate triage criterion following the “abnormal vital signs” step increased sensitity (99.8%) with a severe decrease in specificity (1.6%). Coupling abnormal vital signs with high-risk mechanisms at this step slightly decreased sensitivity (90.4%), but increased specificity (48.5%).

†Patient choice (patients requesting a specific hospital) was considered as an additional predictor in decision rule derivation. This factor was not predictive of patients with ISS ≥ 16 or serious chest injuries. However, the lack of patient choice (hospitals selected by EMS for reasons other than patient choice) increased the probability of having serious abdominal injury and serious TBI. This factor may represent another aspect to consider in the out-of-hospital risk assessment of older patients.