Table 3: NFTI Adjusted CMM Model.
Trauma Triage Status |
CMM (Cribari Matrix Method) |
ISS (Injury Severity Score) |
NFTI (Need for Trauma Intervention) |
|
CMM offers trauma facilities the opportunity to evaluate under-triaging and over-triaging percentages among trauma patient populations.
This matrix couples the degree of trauma team activation (none, partial, full) with one category of ISS score dichotomized into > 15 and </= 15 [3]. |
ISS criteria consist of a complex rating system that utilizes Abbreviated Injury Scales (AIS) for six body regions: · Head and neck, · Face, · Chest, · Abdomen or pelvis, · Extremities or pelvic girdle, · External surface.
To create a generalized injury score, ISS = sum of the individually squared three highest AIS scored body regions (sum of squares) ISS score > 15 is major trauma and requires trauma activation [2]. |
NFTI positive (NFTI+) = Major Trauma: · Receiving packed red blood cells (PRBC) within the first four hours of arrival, · Transferred from emergency room (ER) to operating room (OR) within 90 minutes of arrival, · Transferred from ER to interventional radiology (IR), · Transferred to intensive care unit (ICU) and have a total ICU LOS >/= 3 days · Receiving mechanical ventilation other than procedural anesthesia for the first three days · Having a length of stay (LOS) of >/= 3 calendar days, · And/or death within 60 hours of hospital arrival [6]. |
UNDER |
|
ISS > 15 AND receiving partial or no trauma activation |
If NFTI+, then under-triaged; If NFTI-, then appropriately triaged. |
Appropriate |
|
ISS > 15 AND trauma activation; |
NFTI+; |
|
ISS ≤ 15 and no trauma activation |
NFTI- |
|
Over |
|
ISS ≤ 15 and receiving full trauma team activation |
If NFTI+, then appropriately triaged; If NFTI-, then over-triaged. |
This is a revised version of CMM that re-evaluates triage appropriateness by applying NFTI criteria to patients if triage status was not appropriate.
NFTI: Need for Trauma Intervention; CMM: Cribari Matrix Method; ISS: Injury Severity Score; AIS: Abbreviated Injury Score; PRBC: Packed Red Blood Cells; ER: Emergency Room; OR: Operating Room; IR: Interventional Radiology; ICU: Intensive Care Unit; LOS: Length of Stay.