World Journal of Surgery

, Volume 39, Issue 2, pp 356–362 | Cite as

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

  • Bryce Haac
  • Carlos Varela
  • Andrew Geyer
  • Bruce Cairns
  • Anthony Charles
Original Scientific Report



Trauma scoring systems have been developed to assess injury severity and may have triage potential. We sought to evaluate the ability of the Kampala trauma score (KTS) to assess injury severity and its potential as an outcome predictive tool in Malawi.


This is a prospective cohort study of trauma patients presenting to Kamuzu Central Hospital in 2012. We recorded admission KTS and Revised trauma score (RTS), emergency department disposition, and hospital length of stay (LOS) and survival. Logistic regression and ROC curve analyses were used to compare the KTS to the widely accepted RTS.


15,617 patients presented with trauma. 2,884 (18 %) were admitted, of which 2,509 (95 %) survived. The mean admission KTS was 14.5 ± 0.6, and RTS was 11.9 ± 0.3. For KTS and RTS, the odds of admission with each increment increase in score was 0.44 and 0.3, respectively. Similarly, odds of mortality is 0.48 and 0.36. Neither KTS (p = 0.96, ROC area 0.5) nor RTS (p = 0.25, ROC area 0.5) correlated significantly with hospital LOS. KTS and RTS performed equally well as predictors of mortality, but KTS was a better predictor of need for admission (KTS ROC area 0.62, RTS ROC area 0.55, p < 0.001).


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.


Trauma Patient Injury Severity Score Revise Trauma Score Patient Demographic Information Abnormal Vital Sign 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors wish to thank Jared Tomlinson MD for his help in facilitating data collection. This research was supported by the Doris Duke Charitable Foundation; The UNC Institute of Global Health and Infectious Diseases; the UNC Center for AIDS Research.


  1. 1.
    World Health Organization (WHO) (2002) World report on violence and health. WHO, GenevaGoogle Scholar
  2. 2.
    Berger L, Mohan D (1996) Injury Control: A Global View. Oxford University Press, New YorkGoogle Scholar
  3. 3.
    World Health Organization (WHO) (2010) Injuries and violence: the facts. WHO, SwitzerlandGoogle Scholar
  4. 4.
    Mathers CD, Sadana R, Salomon JA et al (2001) Healthy Life Expectancy in 191 Countries, 1999. Lancet 357:1685–1691PubMedCrossRefGoogle Scholar
  5. 5.
    World Health Organization (WHO) (2002) The Injury Chart Book. Geneva, Switzerland. Available at Accessed 5 April 2014Google Scholar
  6. 6.
    World Health Organization (WHO) (2006) The World Health Report 2006: working together for health. Geneva. Available at Accessed 5 April 2014
  7. 7.
    World Health Organization (WHO) WHO Africa region: Malawi statistics summary (2002 to present). Available at Accessed 5 April 2014
  8. 8.
    World Health Organization (WHO) Noncommunible diseases country profiles 2011. Available at Accessed 5 April 2014
  9. 9.
    Baker S, O’Neill B, Haddon W et al (1974) The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 14:187–196PubMedCrossRefGoogle Scholar
  10. 10.
    Boyd C, Tolson M, Copes W (1987) Evaluating trauma care: the TRISS method. J Trauma 27:370–378PubMedCrossRefGoogle Scholar
  11. 11.
    Champion H, Sacco W (1989) A revision of the trauma score. J Trauma 29:623–629PubMedCrossRefGoogle Scholar
  12. 12.
    Kingston R, O’Flanagan SJ (2000) Scoring systems in trauma. Ir J Med Sci 169(3):168–172PubMedCrossRefGoogle Scholar
  13. 13.
    Kobusingye OC, Lett RR (2000) Hospital-based trauma registries in Uganda. J Trauma 48(3):498–502PubMedCrossRefGoogle Scholar
  14. 14.
    MacLeod JBA, Kobusingye O, Frost C et al (2003) 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? Eur J Trauma 29(6):392–398CrossRefGoogle Scholar
  15. 15.
    Samuel JC, Akinkuotu A, Baloyi P et al (2010) Hospital-based injury data in Malawi: strategies for data collection and feasibility of trauma scoring tools. Trop Doctor 40(2):98–99CrossRefGoogle Scholar
  16. 16.
    Chalya PL, Mabula JB, Dass RM et al (2012) Injury characteristics and outcome of road traffic crash victims at Bugando Medical Center in Northwestern Tanzania. J Trauma Manag Outcomes 6(1):1PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2014

Authors and Affiliations

  • Bryce Haac
    • 1
  • Carlos Varela
    • 2
  • Andrew Geyer
    • 3
  • Bruce Cairns
    • 1
  • Anthony Charles
    • 1
  1. 1.Department of Surgery,UNC School of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Department of SurgeryKamuzu Central HospitalLilongweMalawi
  3. 3.Air Force Institute of Technology (AFIT/ENC)Wright-Patterson AFBUSA

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