Avoiding Cribari gridlock 2: The standardized triage assessment tool outperforms the Cribari matrix method in 38 adult and pediatric trauma centers |
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| Institution: | 1. 3409 Worth St, Pickens Building, Ste C2.500, Dallas, TX 75246 USA;2. 2500 Rocky Mountain Ave, Loveland, CO 80538 USA;3. 2525 Chicago Ave, Minneapolis, MN 55404 USA;4. 890 West Faris Rd, Ste 310, Greenville, SC 29605 USA;5. 9100 East Mineral Cir, Centennial, CO 80112 USA;6. 11600 West 2nd Pl, Lakewood, CO 80228 USA;7. 1500 South Main St, Fort Worth, TX 76104 USA;8. Trauma Center, 80 Dudley St, Providence, RI 02905 USA;9. Surgical Research, 593 Eddy St, Nursing Arts Building #213, Providence, RI 02903 USA;10. 2401 South 31st St, Temple, TX 76508 USA;11. 900 23rd St, NW, Washington, DC 20037 USA;12. 4301 West Markham St, Little Rock, AR 72205 USA;13. Trauma and Acute Care Surgery, 8701 Watertown Plank Rd, Milwaukee, WI 53226 USA;14. 200 Campus Dr, #400, Hershey, PA 17033 USA;15. 4001 Burnett-Womack Building, CB #7050, Chapel Hill, NC 27599 USA;p. 1935 Medical District Dr, Dallas, TX 75235 USA;q. 1500 Cooper St, Fort Worth, TX 76104 USA;r. 615 North Wolfe St, Baltimore, MD 21205 USA;s. 221 West Colorado Blvd #425, Dallas, TX 75208 USA;t. 3401 Civic Center Blvd, Philadelphia, PA 19104 USA;u. 2500 Rocky Mountain Ave, Loveland, CO 80538 USA;v. 333 Pine Ridge Blvd, Wausau, WI 54401 USA;w. Trauma Services, 640 Jackson St, Saint Paul, MN 55101 USA;x. 12631 East 17th Ave, Room 6111, Aurora, CO 80045 USA;y. 1400 East Boulder St, Colorado Springs, CO 80909 USA;z. 1650 West College St, Grapevine, TX 76051 USA;11. 100 Michigan St NE, Grand Rapids, MI 49503 USA;1. Department of Orthopaedic Surgery, NorthWest Clinics, Alkmaar, the Netherlands;2. Centre for Orthopaedic Research Alkmaar, NorthWest Clinics, Alkmaar, the Netherlands;1. Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou 215006, China;2. Orthopaedic Institute, Medical College, Soochow University, Suzhou 215007, China;3. School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario NZL 3G1, Canada;1. Institute of Epidemiology, Faculty of medicine, University of Belgrade, Belgrade, Serbia;2. Laboratory for Molecular Biomedicine, Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Serbia;3. Institute of Human Genetics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia;4. Department of Surgery and Anesthesia, School of Medicine, University of Belgrade, Belgrade, Serbia;5. Center for Anesthesia and Resuscitation, Clinical Center of Serbia, Belgrade, Serbia;6. Clinic of Pulmonology, Clinical Centre of Serbia, Belgrade, Serbia;1. Department of Orthopaedic Surgery, Faculty of Medicine, University of Thessaly, 3 Panepistimiou St, Biopolis 41500 Larissa, Greece;2. Hand, Upper Extremity and Microsurgery Department, IASO Thessalias, Nikaia 41500 Larissa, Greece;1. Division of Orthopaedic Trauma;2. Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, 201, Sec.2, Shih-Pai Rd. Taipei 112, Taiwan;3. Department of Orthopaedics, School of Medicine, National Yang-Ming University;4. Division of Medical Imaging for Health Management, Cheng-Hsin General Hospital;5. Department of Radiology, School of Medicine, National Yang-Ming University |
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| Abstract: | ObjectivesThe Cribari Matrix Method (CMM) is the current standard to identify over/undertriage but requires manual trauma triage reviews to address its inadequacies. The Standardized Triage Assessment Tool (STAT) partially emulates triage review by combining CMM with the Need For Trauma Intervention, an indicator of major trauma. This study aimed to validate STAT in a multicenter sample.MethodsThirty-eight adult and pediatric US trauma centers submitted data for 97,282 encounters. Mixed models estimated the effects of overtriage and undertriage versus appropriate triage on the odds of complication, odds of discharge to a continuing care facility, and differences in length of stay for both CMM and STAT. Significance was assessed at p <0.005.ResultsOvertriage (53.49% vs. 30.79%) and undertriage (17.19% vs. 3.55%) rates were notably lower with STAT than with CMM. CMM and STAT had significant associations with all outcomes, with overtriages demonstrating lower injury burdens and undertriages showing higher injury burdens than appropriately triaged patients. STAT indicated significantly stronger associations with outcomes than CMM, except in odds of discharge to continuing care facility among patients who received a full trauma team activation where STAT and CMM were similar.ConclusionsThis multicenter study strongly indicates STAT safely and accurately flags fewer cases for triage reviews, thereby reducing the subjectivity introduced by manual triage determinations. This may enable better refinement of activation criteria and reduced workload. |
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