PREDICTIVE-VALIDITY AND INTERNAL CONSISTENCY OF THE PREHOSPITAL INDEXMEASURED ON-SITE BY PHYSICIANS

Physiological measures of injury are used as triage tools to identify patients that require treatment in trauma centres. The Pre-Hospital In dex (PHI) is based on systolic blood pressure, pulse, respiratory rate , (level of) consciousness, and presence of penetrating injury. The pr esent study evaluated the validity and internal consistency of the PHI . The study was based on 628 patients assessed by physicians at the sc ene. Mean age was 38.7 years (SD=24.8), and 65% were male. Motor vehic le collisions caused the injury for 45%. The majority had head/neck (5 6%) and extremity (45%) injuries. Mean PHI was 4.62 (SD=5.77), 40% had a PHI of zero, 6% between 1 and 3, 32% between 4 and 7, and 21% great er than 7. The associations between PHI and rates of hospital admissio n, surgery, ICU treatment, mortality, duration of hospitalization, and length of ICU stay were significant (p <0.001). A total of 260 (41.4% ) patients had major trauma requiring treatment at a trauma centre. A PHI >3 had 83% sensitivity and 67% specificity for identifying these p atients. Internal consistency of the PHI variables was above the accep table limits. This study has shown that the PHI is a valid and reliabl e physiological measure of injury severity and field triage tool. Copy right (C) 1996 Elsevier Science Ltd.