The Suitability of the South African Triage Scale (SATS) in Triaging Patients With Penetrating Neck Injuries at a High-Level Trauma Center, in the Western Cape, South Africa.

Abstract

Penetrating injuries are the most common mechanism of serious injury in Cape Town, with penetrating neck injuries (PNIs) having a mortality rate of 10%. The South African Triage Scale (SATS) is commonly used and designed for general emergency departments in South Africa. This study aimed to assess the suitability of the SATS for triaging patients with PNIs at a high-level trauma center, Tygerberg Hospital (TBH). This secondary analysis utilized data from a multicentre prehospital observational study. Adult patients (≥ 18 years) with PNIs managed at the TBH Trauma Center between October 2022 and March 2023 were included. Patients dead on arrival were excluded. The original arrival triage categorization was reviewed and re-calculated based on a correct application of the SATS. Seventy patients (mean age: 32 years, SD: 10) were included. Mechanisms of injury were stab or cut (78.6%) and gunshot wound (21.4%). The most common SATS colors recorded were Orange (61.4%), and Yellow (17.1%), with recalculation of SATS (R-SATS) resulting in "Orange" (81.4%) and "Red" (18.6%). Under-triage occurred in 25.7% of cases. A significant difference was noted between SATS and R-SATS categories (p < 0.01). There was no significant association between TBH SATS or R-SATS category and need for resuscitation, urgent surgical intervention, and 7-day mortality (p > 0.05). No association could be shown between the SATS colors and life-saving interventions and mortality. Furthermore, findings suggest that the SATS is not optimally applied at TBH. Consideration for a simpler, better-performing tool to optimize triage of patients with traumatic injuries, including PNIs is needed.