Comparison of Kampala Trauma Score and Trauma Injury Severity Score in Predicting Mortality in Trauma Patients

Abstract

Introduction: Trauma is one of the leading causes of mortality and morbidity worldwide. The mechanism of trauma is classified as either blunt or penetrating. Blunt trauma is due to motor vehicle-related injuries, falls, and assaults, whereas firearms and stabbings account for most penetrating injuries. Fifty percent of deaths occur within minutes of injury, resulting from massive bleeding or severe neurologic damage. This study aims to assess the Kampala Trauma Score and Trauma Injury Severity Score system with the outcome, i.e., mortality. Methods: It is a prospective descriptive cohort study. A total of 285 patients were involved in the study. All patients suspected of having trauma were scored using TRISS and KAMPALA SCORES at arrival time. Clinical assessment, relevant blood investigations, and radiological investigations were done in the emergency department at the time of presentation in a tertiary care teaching hospital and repeated after 24 hours. The follow-up for mortality till the 30th post-trauma day was recorded. Physiological parameters at the time of initial assessment were recorded, including Systolic Blood Pressure (SBP), Glasgow Coma Scale (GCS) score, respiratory rate (RR), heart rate (HR), and oxygen saturation2. Chest X-ray, CT scan, USG abdomen and pelvis, and blood investigation were done when indicated. Results: Of the 285 patients eligible for the study, mortality was 21(13.57%). The area under the curve for TRISS and KTS were 0.951 and 0.980, respectively, at the time of admission and 0.955 and 0.989 after 24 hours. The diagnostic accuracy of KTS was higher than the TRISS, indicating that KTS was better at predicting mortality in trauma patients than the complex TRISS. Conclusion: The Kampala Trauma Scoring System is better at predicting mortality than the Trauma Injury Severity Scoring System in trauma patients. It predicted early and late mortality better with better diagnostic accuracy than the TRISS.