Assessing the performance of the updated 2021 Field Triage Guidelines with the Need For Trauma Intervention (NFTI) metric.
American journal of surgery · 2025-11-21 · Method & validation
Abstract
BACKGROUND: Pre-hospital triage is critical for resource-allocation and patient-outcomes. This study aimed to assess the sensitivity (SN) of updated 2021 Field Triage Guidelines (FTGs) and trauma center activation criteria (TAC) related to Need for Trauma Intervention (NFTI). METHODS: Data were collected to identify FTGs Red Criteria (RC) and Yellow Criteria (YC) and NFTI: pRBC within 4 h, operating room within 90 min, interventional radiology, ICU length-of-stay ≥3 days, mechanical ventilation within 3 days, or death within 60 h. SN was analyzed for RC and TAC. Lastly, logistic regressions assessed covariates associated with under-triage (UT). RESULTS: 319 patients were included. SN of RC and TAC were 79 % and 77 %, respectively. Regression analysis showed UT by RC and TAC was associated with blunt mechanism. CONCLUSIONS: FTGs did not meet ACS goals of ≤5 % UT and ≤35 % OT with blunt mechanism being associated with UT.