45 - UNDERTRIAGE RISK AMONG THOSE WITH INTRACRANIAL HEMORRHAGE IN A REGIONAL HOSPITAL TRAUMA NETWORK

Objectives: The process of interfacility transfer may cause a delay in the necessary medical treatment, which could lead to poor outcomes and increased mortality rates. The ACS-COT considers an acceptable undertriage rate of < 5%.

Methods: This is a single-center study of Trauma Registry data, from July 1, 2016, to October 31, 2021. The inclusion criteria were based upon age (≥40 years) and interfacility transfer. Under triage using the Cribari Matrix Method was the dependent variable. A logistic regression was performed to ascertain the effects of predictor variables on the likelihood that an adult ICH trauma patient experienced undertriage.

Results: 878 patients were included in the analysis based on the methods section's requirements; 168 (19%) experienced an undertriage. The logistic regression model was statistically significant (N=837, p< 0.01). In addition, several significant increases in odds for undertriage were identified, which included increasing ISS (OR=1.41, p< 0.01), increasing AIS head region (OR=6.088, p< 0.01), and mental health disorders (OR=4.188, p=.02). In addition, a reduction in odds in ICH adult trauma undertriage is the comorbidity of anticoagulant therapy (OR=.256, p< 0.01).

Conclusion: The likelihood of undertriage in the adult ICH trauma population is associated with increasing AIS head injuries, increasing ISS, and among those with mental health comorbidities. This evidence, along with additional protective factors, such as patients on anticoagulant therapy, may aid in education and outreach efforts to reduce undertriage among the regional referring centers.