Abstract: Objective: To systematically review the diagnostic value of trauma team activation criteria for patients with severe trauma in the emergency department triage. Methods: We searched databases including PubMed, Embase, The Cochrane Library, etc, to collect studies about trauma team activation criteria for patients with severe trauma and Meta-analysis was performed. Results: A total of 13 studies were included, with a total of 16 827 patients. The results of the Meta-analysis showed that the pooled sensitivity (Sen), specificity (Spe), positive likelihood ratio (+LR), negative likelihood ratio (–LR) and diagnostic odds ratio (DOR) of the two-step trauma team activation criteria for patients with severe trauma were 0.69 [95% CI (0.54, 0.80)], 0.87 [95% CI (0.74, 0.94)], 5.3 [95% CI (2.6, 10.8)], 0.36 [95% CI (0.24, 0.53)], 15[95% CI (6, 35)], respectively; and 0.85 [95% CI (0.81, 0.89)], 0.61 [95% CI (0.44, 0.75)], 2.2 [95% CI (1.4, 3.3)], 0.24 [95% CI (0.15, 0.38)], 9 [95% CI (4, 21)] respectively for the three-step criteria. The two-step and three-step activation criteria predicted the area under the SROC curve AUC of severe trauma patients to be 0.8508 and 0.8231, respectively, and the difference between the two was not statistically significant (P>0.05). The results of the subgroup analysis showed that different evaluation initiators and reference standards could have an impact on the evaluation and implementation of the accuracy of the activation criteria. Conclusion: The two-step and three-step trauma team activation criteria have similar diagnostic values in identifying severe trauma patients in the emergency triage. In order to ensure that patients with severe trauma receive the best treatment in time while reducing the waste of medical resources, it is recommended that the trauma team be launched in layers. Limited by the quality and quantity of included studies, the above conclusion still need more high-quality studies to verify.

Key words: trauma team; severe trauma; triage; diagnostic test; Meta-analysis