Are Trauma Team Activations Essential and Cost Effective for Rollover Crashes?

Document Type


Publication Date



Background: Motor vehicle crashes (MVCs) are the leading cause of death for ages 2-34 years. Rollover (RO) is defined as any vehicle rotation of ≥ 90° about any longitudinal or lateral axis occurring. The purpose of this study was to determine the cost effectiveness of RO mechanism as the sole triage criteria.

Methods: Detailed patient injury, demographics, costs and crash information were obtained on patients >16 years and seen at an ACS COT-verified level I trauma center from 2007-2008. Analysis was performed using SPSS v 17.

Results: 257 RO crash occupants were treated at this study center. The frequency of AIS ≤2 in these RO occupants was 74%. Table 1 delineates transport mechanism and trauma team activation (TTA) by type. 62% (133/214) of patients triaged as partial TTA (PTTA) were discharged from the emergency department (ED) (figure 1), whereas all full TTA (FTTA) patients were admitted. 60% of all RO patients were reported to have utilized seat belts. Seat belt use decreased the risk of injury by four-fold (95% CI, 2.14-8.01). No other patient or crash characteristics contributed to this excess triage rate. Based on an average cost of $6,000/TTA and our excess ED discharge rate exceeding the accepted national average rate of 37%, this trauma center could save $498,000/year. Applying the same cost analysis to the NASS database could save $190 million annually to the trauma systems nationally.