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.