Emergency and Trauma Care Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Emerg Med. 2024 May 14;24(1):82. doi: 10.1186/s12873-024-00989-w.
The classification of trauma patients in emergency settings is a constant challenge for physicians. However, the Injury Severity Score (ISS) is widely used in developed countries, it may be difficult to perform it in low- and middle-income countries (LMIC). As a result, the ISS was calculated using an estimated methodology that has been described and validated in a high-income country previously. In addition, a simple scoring tool called the Kampala Trauma Score (KTS) was developed recently. The aim of this study was to compare the diagnostic accuracy of KTS and estimated ISS (eISS) in order to achieve a valid and efficient scoring system in our resource-limited setting.
We conducted a cross-sectional study between December 2020 and March 2021 among the multi-trauma patients who presented at the emergency department of Imam Reza hospital, Tabriz, Iran. After obtaining informed consent, all data including age, sex, mechanism of injury, GCS, KTS, eISS, final outcome (including death, morbidity, or discharge), and length of hospital stay were collected and entered into SPSS version 27.0 and analyzed.
381 multi-trauma patients participated in the study. The area under the curve for prediction of mortality (AUC) for KTS was 0.923 (95%CI: 0.888-0.958) and for eISS was 0.910 (95% CI: 0.877-0.944). For the mortality, comparing the AUCs by the Delong test, the difference between areas was not statistically significant (p value = 0.356). The diagnostic odds ratio (DOR) for the prediction of mortality KTS and eISS were 28.27 and 32.00, respectively.
In our study population, the KTS has similar accuracy in predicting the mortality of multi-trauma patients compared to the eISS.
在急救环境中对创伤患者进行分类对医生来说是一项持续的挑战。然而，损伤严重度评分（ISS）在发达国家得到广泛应用，但在中低收入国家（LMIC）可能难以实施。因此，ISS 是使用以前在高收入国家描述和验证的估计方法计算的。此外，最近还开发了一种名为坎帕拉创伤评分（KTS）的简单评分工具。本研究旨在比较 KTS 和估计的 ISS（eISS）的诊断准确性，以便在我们资源有限的环境中获得有效和高效的评分系统。
我们于 2020 年 12 月至 2021 年 3 月在伊朗大不里士伊玛目礼萨医院的急诊部进行了一项多创伤患者的横断面研究。在获得知情同意后，收集并输入所有数据，包括年龄、性别、损伤机制、GCS、KTS、eISS、最终结局（包括死亡、发病率或出院）和住院时间进入 SPSS 版本 27.0 并进行分析。
381 名多创伤患者参与了研究。KTS 预测死亡率的曲线下面积（AUC）为 0.923（95%CI：0.888-0.958），eISS 为 0.910（95%CI：0.877-0.944）。对于死亡率，通过 Delong 检验比较 AUC，差异无统计学意义（p 值=0.356）。KTS 和 eISS 预测死亡率的诊断优势比（DOR）分别为 28.27 和 32.00。
在我们的研究人群中，KTS 在预测多创伤患者的死亡率方面与 eISS 具有相似的准确性。
