Jurnal Internasional Afrika vol.9 issue.4 2019
African Journal of Emergency Medicine
Evaluating trauma scoring systems for patients presenting with gunshot injuries to a district-level urban public hospital in Cape Town, South Africa
Dublin Core
Title
Jurnal Internasional Afrika vol.9 issue.4 2019
African Journal of Emergency Medicine
Evaluating trauma scoring systems for patients presenting with gunshot injuries to a district-level urban public hospital in Cape Town, South Africa
African Journal of Emergency Medicine
Evaluating trauma scoring systems for patients presenting with gunshot injuries to a district-level urban public hospital in Cape Town, South Africa
Subject
Trauma
Severity
Prediction
Mortality
South Africa
Gunshot
Severity
Prediction
Mortality
South Africa
Gunshot
Description
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 cal-
culate 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.
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 cal-
culate 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.
Creator
Amalia Liljequist Aspelund, Mohamed Quraish Patel, Lisa Kurland, Michael McCaul, Daniël Jacobus van Hoving
Source
https://doi.org/10.1016/j.afjem.2019.07.004
Date
24 July 2019
Contributor
PERI IRAWAN
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Citation
Amalia Liljequist Aspelund, Mohamed Quraish Patel, Lisa Kurland, Michael McCaul, Daniël Jacobus van Hoving, “Jurnal Internasional Afrika vol.9 issue.4 2019
African Journal of Emergency Medicine
Evaluating trauma scoring systems for patients presenting with gunshot injuries to a district-level urban public hospital in Cape Town, South Africa,” Repository Horizon University Indonesia, accessed February 3, 2025, https://repository.horizon.ac.id/items/show/1800.
African Journal of Emergency Medicine
Evaluating trauma scoring systems for patients presenting with gunshot injuries to a district-level urban public hospital in Cape Town, South Africa,” Repository Horizon University Indonesia, accessed February 3, 2025, https://repository.horizon.ac.id/items/show/1800.