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Published on: August 5, 2014
Assessing Trauma Triage Tools: The Cribari Matrix Method and Modified Need for Trauma Intervention
Olivia Houck1, Nathaniel C Brophy, Danielle Rossler
1Author Affiliations: Regional Trauma Data Specialist Northern Ohio Trauma System (Houck, Arida), Trauma and Acute Care Surgery, Trauma Research Scientist, Parkview Regional Medical Center (Brophy), Trauma Program Manager Northern Ohio Trauma System (Rossler), Regional Data Systems Coordinator Central Ohio Trauma System Columbus Ohio (Giambri), CAISS Trauma Data System Specialist Mercy Health St. Vincent Medical Center, Nationwide Children's Toledo Ohio (Moore), CCNS Trauma Program Manager/Clinical Nurse Specialist Kettering Health Main Campus, Kettering, Ohio (Campbell); andTrauma and Acute Care Surgery, Trauma Research Medical Director, Parkview Regional Medical Center (George).
Background:
Assessment of triage procedures is crucial for improving patient care. Most programs evaluate under- and over-triage using the ISS-based Cribari Matrix Method (CMM), but tools such as the critical-intervention-based Need for Trauma Intervention (NFTI) and its time-critical modified version (mNFTI) focus on identifying patients who need immediate resources. The mNFTI has seen limited empirical inquiry in assessing triage procedures.
Objective:
To assess accuracy and agreement rates between mNFTI and CMM.
Methods:
This multicenter, retrospective cohort study compared triage classifications in trauma patients using 2019 trauma registry data from trauma centers across 5 trauma systems in Ohio, United States. Patients meeting Ohio/National Trauma Data Standards for traumatic injury were included. Triage classifications were assigned by mNFTI and CMM and compared across all patients and injury subgroups using statistical tests (McNemar, symmetry, Cohen Kappa) to determine agreement and differences between the 2 methods.
Results:
The final analysis included 27,637 patients. Patient count tables show classification differences for all patients and injury subgroups. The statistical tests reveal differences in retrospective triage assessment by the mNFTI and CMM. Among 27,637 patients, mNFTI and CMM classifications differed significantly at both the population and subgroup levels ( p < .05 for all comparisons). The agreement between methods was weak to moderate.
Conclusions:
This study demonstrates that mNFTI produces significantly different trauma triage classifications compared with the Cribari Matrix Method, with moderate agreement between the 2. These differences suggest that mNFTI may better identify patients who require immediate trauma intervention and could help address undertriage in trauma systems. Further research is warranted to validate mNFTI as a stand-alone quality metric for trauma triage.
