Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, PA; Department of Anesthesia and Critical Care Medicine, Division of Adult Critical Care Medicine, Johns Hopkins University, Baltimore, MD.
Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa; Department of Surgery, University of Kwa-Zulu Natal, Durban, South Africa.
Surgery. 2020 May;167(5):836-842. doi: 10.1016/j.surg.2020.01.009. Epub 2020 Feb 21.
The Injury Severity Score and Trauma and Injury Severity Score are used commonly to quantify the severity of injury, but they require comprehensive data collection that is impractical in many low- and middle-income countries . We sought to develop an injury score that is more feasible to implement in low- and middle-income countries with discrimination similar to the Injury Severity Score and the Trauma and Injury Severity Score.
Clinical data from KwaZulu-Natal, South Africa were used to compare the discrimination of the Injury Severity Score and the Trauma and Injury Severity Score with that of the 5, simple injury scores that rely primarily on physiologic data: Revised Trauma Score for Triage, "Mechanism, Glasgow Coma Scale, Age, Pressure" Score, Kampala Trauma Score, modified Kampala Trauma Score, and "Reversed Shock Index Multiplied by Glasgow Coma Scale" Score.
Data for 3,991 patients were analyzed. The Trauma and Injury Severity Score, the Injury Severity Score, and Kampala Trauma Score had similar discrimination (area under the receiver operating curve 0.85, 0.84, and 0.84, respectively). The simple injury scores demonstrated worse discrimination among patients presenting more than 6 hours postinjury, although Kampala Trauma Score maintained the best discrimination of the simple injury scores.
In this patient population, Kampala Trauma Score demonstrated discrimination similar to the Injury Severity Score and the Trauma and Injury Severity Score and may be useful to quantify the severity of injury when calculation of the Injury Severity Score or the Trauma and Injury Severity Score is not feasible. Delay in presentation can degrade the discrimination of simple injury scores that rely primarily on physiologic data.
损伤严重度评分和创伤与损伤严重度评分常用于量化损伤的严重程度，但它们需要全面的数据收集，在许多中低收入国家并不实际。我们试图开发一种在中低收入国家更可行的损伤评分，其区分度与损伤严重度评分和创伤与损伤严重度评分相似。
使用南非夸祖鲁-纳塔尔省的临床数据，比较损伤严重度评分和创伤与损伤严重度评分与主要依赖生理数据的 5 种简单损伤评分的区分度：创伤分诊修订创伤评分、“机制、格拉斯哥昏迷量表、年龄、压力”评分、坎帕拉创伤评分、改良坎帕拉创伤评分和“反转休克指数乘以格拉斯哥昏迷量表”评分。
分析了 3991 例患者的数据。创伤与损伤严重度评分、损伤严重度评分和坎帕拉创伤评分的区分度相似（受试者工作特征曲线下面积分别为 0.85、0.84 和 0.84）。在受伤后 6 小时以上就诊的患者中，简单损伤评分的区分度较差，尽管坎帕拉创伤评分保持了简单损伤评分中最佳的区分度。
在该患者人群中，坎帕拉创伤评分的区分度与损伤严重度评分和创伤与损伤严重度评分相似，在无法计算损伤严重度评分或创伤与损伤严重度评分时，可能有助于量化损伤的严重程度。主要依赖生理数据的简单损伤评分的区分度会因延迟就诊而降低。
