SUPPLEMENTAL DIGITAL CONTENT
SDC eTable 1: Sensitivity Analysis—isolated NFTG Step 2 criteria: Patient Demographics, Prehospital Characteristics, and Outcomes
SDC eTable 2: EMS Identification Rate, Prevalence, & TCN by ICD-10 and EMS for isolated NFTG Step 2 criteria
SDC eTable 3: Diagnostic Performance: Predicting TCN using ICD-10 Diagnosis Coding versus EMS Identified Criteria for isolated NFTG Step 2 Criteria
SDC eTable 1. Sensitivity Analysis—isolated NFTG Step 2 criteria: Patient Demographics, Prehospital Characteristics, and Outcomes
Total Study Population
n=669,795
EMS Step 2 NFTG Positive
n= 35,427
ICD-10 Step 2 NFTG Positive n=205,291
p value
Age 53 (32, 71) 35 (25, 50) 47 (29, 64) <0.001
Male sex 394,398 (58.9%) 28,115 (79.4%) 140,196 (68.3%) <0.001
ISS 9 (4, 10) 9 (4, 18) 10 (5, 17) <0.001
GCS 15 (15, 15) 15 (14.5, 15) 15 (15, 15) <0.001
SBP 138 (126, 149) 131.2 (112, 145) 135 (122, 146) <0.001
RR 18 (16, 20) 18 (16, 20) 18 (16, 20) <0.001
Mortality 18,455 (3.2%) 2,117 (7.5%) 9,551 (5.3%) <0.001
TCN 229,862 (34.3%) 21,511 (60.7%) 107,227 (52.2%) <0.001
Continuous variables presented as median (IQR) Categorical variables presented as n (%)
EMS, emergency medical services; NFTG, national field triage guidelines; IQR, interquartile range; ISS, injury severity score; GCS, Glasgow Coma Scale; SBP, systolic blood pressure; RR, respiratory rate; TCN, trauma center need (composite outcome of ISS>15, ICU admission, urgent surgery, or emergency department death)
SDC eTable 2: EMS Identification Rate, Prevalence, & TCN by ICD-10 and EMS for isolated NFTG Step 2 criteria
EMS identification rate* Prevalence Trauma Center Need
ICD-10 EMS p-value ICD-10 EMS p-value
Penetrating Injury 31.3% 10.1% 3.4% p<0.01 51.8% 58.5% p<0.01
Flail Chest 1.1% 12.9% 0.2% p<0.01 58.9% 86.8% p<0.01
Open Skull Fracture 6.9% 1.0% 0.2% p<0.01 92.6% 96.4% p<0.01
≥2 Prox. Long Bone Fractures 6.4% 1.8% 0.6% p<0.01 47.4% 81.1% p<0.01
Pelvic Fracture 4.1% 7.1% 0.4% p<0.01 48.2% 72.1% p<0.01
Crush Injury 19.3% 0.1% 0.4% p<0.01 68.1% 84.5% p<0.01
Amputation 26.0% 0.1% 0.1% p<0.01 95.3% 95.5% p=0.92
Paralysis 8.9% 1.5% 0.3% p<0.01 85.5% 95.3% p<0.01
* EMS identification of anatomic injury criterion among patients with anatomic injury present by ICD-10 diagnosis codes
SDC eTable 3: Diagnostic Performance: Predicting TCN using ICD-10 Diagnosis Coding versus EMS Identified Criteria for isolated NFTG Step 2 Criteria
Sensitivity Specificity PPV NPV Accuracy AUC False Neg False Pos p-value
ICD-10 46.9% 77.6% 52.2% 73.7% 67.0% 0.622 53.1% 22.4%
<0.001
EMS 9.4% 96.8% 60.7% 67.2% 66.8% 0.531 90.6% 3.2%
Results represent the overall diagnostic performance for NFTG Steps 2 (anatomic) criteria
TCN, trauma center need; PPV, positive predictive value; NPV, negative predictive value; Neg, negative; Pos, positive