Manoochehry Shahram, Vafabin Masoud, Bitaraf Saeid, Amiri Ali
Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Shiraz University of Medical Sciences, Shiraz, Iran.
Arch Acad Emerg Med. 2019 Jan 15;7(1):e6. eCollection 2019 Winter.
Describing injury severity in trauma patients is vital. In some recent articles the Revised Trauma Score (RTS) and Kampala Trauma Score (KTS) have been suggested as easily performed and feasible triage tools which can be used in resource-limited settings. The present meta-analysis was performed to evaluate and compare the accuracy of the RTS and KTS in predicting mortality in low-and middle income countries (LMICs).
Two investigators searched the Web of Science, Embase, and Medline databases and the articles which their exact number of true-positive, true-negative, false-positive, and false-negative results could be extracted were selected. Sensitivity and subgroup analysis were performed using Stata software version 14 to determine the factor(s) affecting the accuracy of the RTS and KTS in predicting mortality and source(s) of heterogeneity.
The heterogeneity was high (I2 > 80%) among 11 relevant studies (total n = 20,631). While the sensitivity of the KTS (0.88) was slightly higher than RTS (0.82), the specificity, diagnostic odds ratio, negative likelihood ratio, and positive likelihood ratio of the KTS (0.73, 20, 0.16, 3.30, respectively) were lower than those of the RTS (0.91, 45, 0.20, 8.90, respectively). The area under the summary-receiver operator characteristic curve for KTS and RTS was 0.88 and 0.93, respectively.
However, regarding accuracy and performance, RTS was better than KTS for distinguishing between mortality and survival; both of them are beneficial trauma scoring tools which can be used in LMICs. Further studies are required to specify the appropriate choice of the RTS or KTS regarding the type of injury and different conditions of the patient.
描述创伤患者的损伤严重程度至关重要。在最近的一些文章中，修订创伤评分（RTS）和坎帕拉创伤评分（KTS）被认为是易于实施且可行的分诊工具，可用于资源有限的环境。本荟萃分析旨在评估和比较RTS和KTS在预测低收入和中等收入国家（LMICs）死亡率方面的准确性。
两名研究人员检索了科学网、Embase和Medline数据库，并选择了能够提取其真阳性、真阴性、假阳性和假阴性结果确切数量的文章。使用Stata软件版本14进行敏感性和亚组分析，以确定影响RTS和KTS预测死亡率准确性的因素以及异质性来源。
11项相关研究（总计n = 20,631）之间的异质性较高（I2> 80%）。虽然KTS的敏感性（0.88）略高于RTS（0.82），但其特异性、诊断比值比、阴性似然比和阳性似然比（分别为0.73、20、0.16、3.30）低于RTS（分别为0.91、45、0.20、8.90）。KTS和RTS的汇总接受者操作特征曲线下面积分别为0.88和0.93。
然而，在区分死亡率和生存率方面，就准确性和性能而言，RTS优于KTS；两者都是可用于LMICs的有益创伤评分工具。需要进一步研究以根据损伤类型和患者的不同情况确定RTS或KTS的合适选择。
