The Utility of the Kampala Trauma Score as a Triage Tool in a Sub‐Saharan African Trauma Cohort

Haac, Bryce; Varela, Carlos; Geyer, Andrew J.; Cairns, Bruce A.; Charles, Anthony

doi:10.1007/s00268-014-2830-6

Cited by 32 publications

(50 citation statements)

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“…When stratifying MGAP scores as low (23)(24)(25)(26)(27)(28)(29), intermediate (18)(19)(20)(21)(22) and high (3-17) risk for death, the in-hospital mortality rates were uniformly higher than in the original validation cohort of the MGAP score in France (Table 3). The area under the ROC curve for the MGAP score in the French validation cohort was 0.90, compared with 0.85 in the subset of patients with sufficient data to Fig.…”

Section: Resultsmentioning

confidence: 99%

“…One concern is that vital sign measurements occurred at the time of hospital triage, not at a fixed interval after the injury event, which may introduce bias as vital signs fluctuate over time and with resuscitative measures. However, vital signs collected at the time of hospital arrival are routinely used for injury scoring in low-and middle-income countries without adjusting for time since injury [19,22,[26][27][28]. In fact, because physiologic scoring systems do not rely on comprehensive anatomic evaluation, they potentially provide a more feasible means of estimating injury severity in low-and middle-income countries using readily available clinic or administrative data [29].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Choice of injury scoring system in low- and middle-income countries: Lessons from Mumbai

Laytin

Kumar

Juillard

et al. 2015

Injury

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Choice of injury scoring system in low- and middle-income countries: Lessons from Mumbai

Laytin

Kumar

Juillard

et al. 2015

Injury

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“…The Kampala Trauma Score (KTS) has been proposed as a potentially useful triage tool for LMICs 7–9 . KTS may be more practical than other triage tools, such as the South African Triage Scale (SATS), since it requires fewer variables for calculation, and a single algorithm can be applied to all age groups 10,11 .…”

Section: Introductionmentioning

confidence: 99%

“…Studies that attempted to validate KTS prospectively have used a variety of methods for determining number of serious injuries 7–9 . Further, these reports have not described data collection under the pressure of time, which is inherent to emergency care 7–9 .…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of the Kampala Trauma Score using estimated Abbreviated Injury Scale scores and physician opinion

Gardner

Forson

Oduro

et al. 2017

Injury

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Background The Kampala Trauma Score (KTS) has been proposed as a triage tool for use in low- and middle-income countries (LMICs). This study aimed to examine the diagnostic accuracy of KTS in predicting emergency department outcomes using timely injury estimation with Abbreviated Injury Scale (AIS) score and physician opinion to calculate KTS scores. Methods This was a diagnostic accuracy study of KTS among injured patients presenting to Komfo Anokye Teaching Hospital A&E, Ghana. South African Triage Scale (SATS); KTS component variables, including AIS scores and physician opinion for serious injury quantification; and ED disposition were collected. Agreement between estimated AIS score and physician opinion were analyzed with normal, linear weighted, and maximum kappa. Receiver operating characteristic (ROC) analysis of KTS-AIS and KTS-physician opinion was performed to evaluate each measure’s ability to predict A&E mortality and need for hospital admission to the ward or theatre. Results A total of 1,053 patients were sampled. There was moderate agreement between AIS criteria and physician opinion by normal (κ=0.41), weighted (κlin=0.47), and maximum (κmax=0.53) kappa. A&E mortality ROC area for KTS-AIS was 0.93, KTS-physician opinion 0.89, and SATS 0.88 with overlapping 95% confidence intervals (95%CI). Hospital admission ROC area for KTS-AIS was 0.73, KTS-physician opinion 0.79, and SATS 0.71 with statistical similarity. When evaluating only patients with serious injuries, KTS-AIS (ROC 0.88) and KTS-physician opinion (ROC 0.88) performed similarly to SATS (ROC 0.78) in predicting A&E mortality. The ROC area for KTS-AIS (ROC 0.71; 95%CI 0.66–0.75) and KTS-physician opinion (ROC 0.74; 95%CI 0.69–0.79) was significantly greater than SATS (ROC 0.57; 0.53–0.60) with regard to need for admission. Conclusions KTS predicted mortality and need for admission from the ED well when early estimation of the number of serious injuries was used, regardless of method (i.e. AIS criteria or physician opinion). This study provides evidence for KTS to be used as a practical and valid triage tool to predict patient prognosis, ED outcomes and inform referral decision-making from first- or second-level hospitals in LMICs.

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Epidemiology of paediatric injuries in Rwanda using a prospective trauma registry

et al. 2020

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Background: Child survival initiatives historically prioritized efforts to reduce child morbidity and mortality from infectious diseases and maternal conditions. Little attention has been devoted to paediatric injuries in resource-limited settings. This study aimed to evaluate the demographics and outcomes of paediatric injury in a sub-Saharan African country in an effort to improve prevention and treatment.Methods: A prospective trauma registry was established at the two university teaching campuses of the University of Rwanda to record systematically patient demographics, prehospital care, initial physiology and patient outcomes from May 2011 to July 2015. Univariable analysis was performed for demographic characteristics, injury mechanisms, geographical location and outcomes. Multivariable analysis was performed for mortality estimates.Results: Of 11 036 patients in the registry, 3010 (27⋅3 per cent) were under 18 years of age. Paediatric patients were predominantly boys (69⋅9 per cent) and the median age was 8 years. The mortality rate was 4⋅8 per cent. Falls were the most common injury (45⋅3 per cent), followed by road traffic accidents (30⋅9 per cent), burns (10⋅7 per cent) and blunt force/assault (7⋅5 per cent). Patients treated in the capital city, Kigali, had a higher incidence of head injury (7⋅6 per cent versus 2⋅0 per cent in a rural town, P < 0⋅001; odds ratio (OR) 4⋅08, 95 per cent c.i. 2⋅61 to 6⋅38) and a higher overall injury-related mortality rate (adjusted OR 3⋅00, 1⋅50 to 6⋅01; P = 0⋅019). Pedestrians had higher overall injury-related mortality compared with other road users (adjusted OR 3⋅26, 1⋅37 to 7⋅73; P = 0⋅007).Conclusion: Paediatric injury is a significant contributor to morbidity and mortality. Delineating trauma demographics is important when planning resource utilization and capacity-building efforts to address paediatric injury in low-resource settings and identify vulnerable populations.

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The Utility of the Kampala Trauma Score as a Triage Tool in a Sub‐Saharan African Trauma Cohort

Abstract: Both the KTS and RTS were significantly associated with need for admission and final outcome on logistic regression analysis; however, they may not be strong enough predictors to merit their use as a screening tool in our setting.

Cited by 32 publications

References 16 publications

Choice of injury scoring system in low- and middle-income countries: Lessons from Mumbai

Choice of injury scoring system in low- and middle-income countries: Lessons from Mumbai

Diagnostic accuracy of the Kampala Trauma Score using estimated Abbreviated Injury Scale scores and physician opinion

Epidemiology of paediatric injuries in Rwanda using a prospective trauma registry

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