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Evaluating trauma scoring systems for patients presenting with gunshot injuries to a district-level urban public hospital in Cape Town, South Africa
Department of Research and Education, Karolinska Institutet, Stockholm, Sweden.
Department of Surgery, Khayelitsha Hospital, Cape Town, South Africa.
Örebro universitet, Institutionen för medicinska vetenskaper. Department of Research and Education, Karolinska Institutet, Stockholm, Sweden. (Department of Emergency Medicine)
Biostatistics Unit, Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, South Africa.
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2019 (Engelska)Ingår i: African journal of emergency medicine, ISSN 2211-419X, Vol. 9, nr 4, s. 193-196Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Introduction: Trauma scoring systems are widely used in emergency settings to guide clinical decisions and to predict mortality. It remains unclear which system is most suitable to use for patients with gunshot injuries at district-level hospitals. This study compares the Triage Early Warning Score (TEWS), Injury Severity Score (ISS), Trauma and Injury Severity Score (TRISS), Kampala Trauma Score (KTS) and Revised Trauma Score (RTS) as predictors of mortality among patients with gunshot injuries at a district-level urban public hospital in Cape Town, South Africa.

Methods: Gunshot-related patients admitted to the resuscitation area of Khayelitsha Hospital between 1 January 2016 and 31 December 2017 were retrospectively analysed. Receiver Operating Characteristic (ROC) analysis were used to determine the accuracy of each score to predict all-cause in-hospital mortality. The odds ratio (with 95% confidence intervals) was used as a measure of association.

Results: In total, 331 patients were included in analysing the different scores (abstracted from database n = 431, excluded: missing files n = 16, non gunshot injury n = 10, <14 years n = 1, information incomplete to calculate scores n = 73). The mortality rate was 6% (n = 20). The TRISS and KTS had the highest area under the ROC curve (AUC), 0.90 (95% CI 0.83-0.96) and 0.86 (95% CI 0.79-0.94), respectively. The KTS had the highest sensitivity (90%, 95% CI 68-99%), while the TEWS and RTS had the highest specificity (91%, 95% CI 87-94% each).

Conclusions: None of the different scoring systems performed better in predicting mortality in this high-trauma burden area. The results are limited by the low number of recorded deaths and further studies are needed.

Ort, förlag, år, upplaga, sidor
Elsevier, 2019. Vol. 9, nr 4, s. 193-196
Nyckelord [en]
Gunshot, Mortality, Prediction, Severity, South Africa, Trauma
Nationell ämneskategori
Medicin och hälsovetenskap Anestesi och intensivvård
Identifikatorer
URN: urn:nbn:se:oru:diva-79640DOI: 10.1016/j.afjem.2019.07.004ISI: 000503721400007PubMedID: 31890483Scopus ID: 2-s2.0-85070185356OAI: oai:DiVA.org:oru-79640DiVA, id: diva2:1390129
Tillgänglig från: 2020-01-31 Skapad: 2020-01-31 Senast uppdaterad: 2020-02-14Bibliografiskt granskad

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Kurland, Lisa

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