TRAUMA TRIAGE - A COMPARISON OF CRAMS AND TRTS IN A UK POPULATION

The CRAMS scale and the Triage Revised Trauma Score (TRTS) were compar ed to assess their potential use a a prehospital method of activating hospital trauma teams. We studied patients from the resuscitation room of Leeds General Infirmary who had enough data recorded to allow calc ulation of the admission TRTS and CRAMS scale. Patients were defined a s having major injury if they died in hospital, were admitted to the I CU or had an Injury Severity Score (ISS) of >15. Each triage scale was compared by calculating multiple sensitivity/specificity pairs and pl otting the results on a receiver operator (ROC) curve. The optimal cut -offs on each scale were compare directly. Ninety-seven (46 per cent) of a total of 213 patients fulfilled the study criteria for major inju ry. The best cut-off points were a CRAMS of <9 and a TRTS of <12. The TRTS was significantly more specific (0.9 versus 0.75) but at a cost o f poor sensitivity (0.6 versus 0.69, not significant). The performance of both scales was similar when compared on the ROC curve. CRAMS and the TRTS were unable to identify major injuries in our sample with sen sitivity and specificity adequate to support their use of a tool to ac tivate trauma teams in the UK. (C) 1997 Elsevier Science Ltd.