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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).
The modified Need for Trauma Intervention (mNFTI) method shows significant differences in trauma triage classifications compared to the Cribari Matrix Method (CMM). This suggests mNFTI may improve identification of patients needing immediate trauma care.
Area of Science:
- Trauma care and emergency medicine
- Clinical quality assessment
- Public health surveillance
Background:
- Effective trauma triage is essential for optimal patient outcomes.
- Current methods like the Cribari Matrix Method (CMM) primarily assess undertriage and over-triage.
- The modified Need for Trauma Intervention (mNFTI) method focuses on identifying patients requiring immediate resources, but its use in triage assessment is under-researched.
Purpose of the Study:
- To compare the accuracy and agreement of trauma triage classifications between the mNFTI and CMM.
- To evaluate the performance of mNFTI in identifying patients needing urgent trauma intervention.
Main Methods:
- A multicenter, retrospective cohort study analyzed 2019 trauma registry data from Ohio trauma centers.
- Triage classifications were assigned using both mNFTI and CMM for 27,637 trauma patients.
- Statistical tests (McNemar, symmetry, Cohen Kappa) were employed to compare classifications and assess agreement.
Main Results:
- Significant differences in triage classifications were observed between mNFTI and CMM across the entire patient cohort and specific injury subgroups (p < .05).
- The agreement between the two triage methods was found to be weak to moderate.
- Classification differences highlight potential disparities in identifying patients requiring immediate trauma intervention.
Conclusions:
- The mNFTI method yields significantly different trauma triage classifications compared to the CMM.
- The findings suggest mNFTI may offer improved identification of patients needing immediate trauma intervention, potentially reducing undertriage.
- Further validation of mNFTI as a standalone quality metric for trauma triage is recommended.
