European Journal of Trauma

, Volume 29, Issue 6, pp 392–398

A Comparison of the Kampala Trauma Score (KTS) with the Revised Trauma Score (RTS), Injury Severity Score (ISS) and the TRISS Method in a Ugandan Trauma Registry

Is Equal Performance Achieved with Fewer Resources?
  • Jana B. A. MacLeod
  • Olive Kobusingye
  • Chris Frost
  • Ron Lett
  • Fred Kirya
  • Caroline Shulman
Original Article

DOI: 10.1007/s00068-003-1277-5

Cite this article as:
MacLeod, J.B.A., Kobusingye, O., Frost, C. et al. Eur J Trauma (2003) 29: 392. doi:10.1007/s00068-003-1277-5

Abstract

Background:

The public health significance of injuries that occur in developing countries is now recognized. In 1996, as part of the injury surveillance registry in Kampala, Uganda, a new score, the Kampala Trauma Score (KTS) was instituted. The KTS, developed in light of the limited resource base of sub-Saharan Africa, is a simplified composite of the Revised Trauma Score (RTS) and the Injury Severity Score (ISS) and closely resembles the Trauma Score and Injury Severity Score (TRISS).

Patients and Methods:

The KTS was applied retrospectively to a cohort of prospectively accrued urban trauma patients with the RTS, ISS and TRISS calculated. Using ROC (receiver operating characteristics) analysis, logistic regression models and sensitivity and specificity cutoff analysis, the KTS was compared to these three scores.

Results:

Using logistic regression models and areas under the ROC curve, the RTS proved a more robust predictor of death at 2 weeks in comparison to the KTS. However, differences in screening performance were marginal (areas under the ROC curves were 87% for the RTS and 84% for the KTS) with statistical significance only reached for an improved specificity (67% vs. 47%; p < 0.001), at a fixed sensitivity of 90%. In addition, the KTS predicted hospitalization at 2 weeks more accurately.

Conclusion:

The KTS statistically performs comparably to the RTS and ISS alone as well as to the TRISS but has the added advantage of utility. Therefore, the KTS has potential as a triage tool in resource-poor and similar health care settings.

Key Words

Trauma registriesSeverity scoresDeveloping countries

Copyright information

© Urban & Vogel München 2003

Authors and Affiliations

  • Jana B. A. MacLeod
    • 1
  • Olive Kobusingye
    • 2
  • Chris Frost
    • 3
  • Ron Lett
    • 2
  • Fred Kirya
    • 2
  • Caroline Shulman
    • 4
  1. 1.Department of SurgeryEmory School of MedicineAtlantaUSA
  2. 2.Injury Control CenterMakerere Medical SchoolKampalaUganda
  3. 3.Medical Statistics UnitLondon School of Hygiene and Tropical MedicineLondonUnited Kingdom
  4. 4.Department of Infectious and Tropical DiseasesLondon School of Hygiene and Tropical MedicineLondonUnited Kingdom
  5. 5.Assistant Professor of SurgeryEmory University/Grady Memorial Hospital Thomas K. Glenn Memorial BuildingAtlantaUSA