Table 2.
Stepwise accuracy metrics for the field triage of injured older adults using current field triage guidelines and additional triage criteria (n = 5,021).
| Sensitivity | 95% CI | Specificity | 95% CI | Sensitivity | 95% CI | Specificity | 95% CI | |
|---|---|---|---|---|---|---|---|---|
| Outcome: ISS ≥ 16, major non-orthopedic surgery, or
early death |
Outcome: ISS ≥ 16 | |||||||
| Current triage guidelines | 36.6% | (31.2-42.0%) | 90.1% | (89.2-91.0%) | 39.9% | (33.7-46.0%) | 89.9% | (89.0-90.7%) |
| Add: GCS ≤ 14 | 59.2% | (53.3-65.0%) | 65.2% | (63.6-66.7%) | 63.8% | (57.5-70.1%) | 65.1% | (63.5-66.6%) |
| Add: Geriatric-specific vital signs | 70.5% | (65.2-75.9%) | 47.6% | (46.1-49.2%) | 74.4% | (68.5-80.2%) | 47.5% | (46.0-49.0%) |
| Add: Comorbidity count ≥ 2 | 90.3% | (86.8-93.7%) | 17.0% | (15.8-18.1%) | 91.3% | (87.7-94.9%) | 16.9% | (15.7-18.1%) |
| Add: Oral anticoagulant use* | 94.1% | (90.1-98.1%) | 14.0% | (12.6-15.4%) | 95.6% | (91.7-99.5%) | 14.0% | (12.6-15.4%) |
| Outcome: Head AIS ≥ 3 | Outcome: Head, Chest, or Abdominal-Pelvic AIS ≥ 3 | |||||||
| Current triage guidelines | 33.9% | (24.8-43.0%) | 89.5% | (88.6-90.4%) | 28.0% | (21.9-34.1%) | 89.9% | (89.0-90.7%) |
| Add: GCS ≤ 14 | 61.5% | (51.6-71.3%) | 64.9% | (63.4-66.4%) | 51.4% | (44.5-58.3%) | 65.0% | (63.4-66.5%) |
| Add: Geriatric-specific vital signs | 73.2% | (63.9-82.5%) | 47.4% | (45.9-49.0%) | 65.3% | (59.2-71.4%) | 47.5% | (45.9-49.1%) |
| Add: Comorbidity count ≥ 2 | 89.3% | (80.9-97.6%) | 16.8% | (15.5-18.0%) | 82.5% | (77.3-87.7%) | 16.4% | (15.2-17.6%) |
| Add: Oral anticoagulant use* | 94.2% | (87.5-100%) | 13.9% | (12.5-15.3%) | 89.2% | (83.3-95.1%) | 13.7% | (12.3-15.2%) |
| Outcome: 30-day mortality | Outcome: 1-year mortality | |||||||
| Current triage guidelines | 15.7% | (11.0-20.4%) | 88.6% | (87.8-89.5%) | 11.3% | (9.3-13.2%) | 88.3% | (87.3-89.3%) |
| Add: GCS ≤ 14 | 54.1% | (47.2-61.0%) | 64.5% | (63.0-66.1%) | 45.0% | (41.7-48.2%) | 65.9% | (64.1-67.6%) |
| Add: Geriatric-specific vital signs | 71.1% | (65.1-77.2%) | 47.3% | (45.7-48.8%) | 63.2% | (60.1-66.2%) | 49.0% | (47.2-50.7%) |
| Add: Comorbidity count ≥ 2 | 94.4% | (91.4-97.4%) | 17.0% | (15.9-18.2%) | 93.5% | (92-95.1%) | 19.1% | (17.8-20.5%) |
| Add: Oral anticoagulant use* | 96.0% | (92.3-99.7%) | 13.9% | (12.5-15.3%) | 95.0% | (93.1-96.9%) | 15.7% | (14.1-17.3%) |
*
When use of anticoagulant medication replaces comorbidity count in the decision rule, sensitivity and specificity are: 78.9% and 40.8% for ISS ≥ 16 or major non-orthopedic surgery; 83.3% and 40.8% for ISS ≥ 16; 82.1% and 40.7% for head AIS ≥ 3; 74.7% and 40.7% for head, chest, or abdominal-pelvic AIS ≥ 3; 80.1% and 40.5% for 30-day mortality; and 69.9% and 42.1% for 1-year mortality.