title: The utility of the Kampala trauma score as a triage tool in a sub-Saharan African trauma cohort.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery,UNC School of Medicine, University of North Carolina at Chapel Hill, 4008 Burnett Womack Building, Chapel Hill, 7228, USA.
authors.forename: Bryce
authors.initials: B
authors.lastname: Haac
authors.forename: Carlos
authors.initials: C
authors.lastname: Varela
authors.forename: Andrew
authors.initials: A
authors.lastname: Geyer
authors.forename: Bruce
authors.initials: B
authors.lastname: Cairns
authors.forename: Anthony
authors.initials: A
authors.lastname: Charles
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008295:Malawi; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015996:Survival Rate; D015599:Trauma Severity Indices; D014218:Triage / Q000379:methods*; D014947:Wounds and Injuries / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D055815:Young Adult