Background: Combining the Need for Trauma Intervention (NFTI) calculation with the Cribari Matrix Method (CMM) more accurately determines appropriate triage, particularly of geriatric trauma patients. These patients (>/= age 65 years) have comorbidities, increased frailty, and decreased overall functional capacity. The CMM alone does not address their increased risk of mortality secondary to inappropriate or suboptimal care; performance improvement efforts to decrease the risk of under-triage have prompted the use of NFTI in this institution.Methods: Geriatric patients presenting to a level 1 trauma center and requiring full or limited trauma team activation or consultation from January 1, 2018 to January 31, 2020 were selected for this retrospective review; 79 undertriaged geriatric patients were included. Those categorized as under-triaged by CMM + Injury Severity Score (ISS) were then analyzed using the NFTI criteria. The hypothesis was that the percent of patients classified as under-triaged would be significantly less following the application of NFTI.Results: Application of NFTI criteria to patients classified as under-triaged by CMM + ISS reduced the study time period under-triage rate from 7.6% to 0.8% for 1,041 trauma activations (P < 0.0003) and 2.5% to 0.3% for 3,123 trauma admissions (P < 0.0003). Conclusion:This study provides evidence of the utility of NFTI-adjusted triage determination in more accurately identifying under-triaged geriatric trauma patients. Further, these results imply the benefit of applying NFTI earlier in the continuum of care, perhaps even requiring the initiation of formal process improvement.

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