Comparison of Six Disaster Triage Methods using the Wenchuan Earthquake Victim Database

Hai Hu
2017 Prehospital and Disaster Medicine  
Study/Objective: To determine the diagnostic accuracy of the Kampala Trauma Score in predicting Emergency Department outcomes in a limited diagnostics setting. Background: The Kampala Trauma Score (KTS) has been proposed as a triage tool for use in low-and middle-income countries (LMICs). This study aimed to examine the diagnostic accuracy of KTS in predicting emergency department (ED) outcomes, using timely injury estimation with Abbreviated Injury Scale (AIS) score, and physician opinion
more » ... Methods: This was a diagnostic accuracy study of KTS among injured patients presenting to Komfo Anokye Teaching Hospital, Ghana. The South African Triage Scale (SATS), KTS and Revised Trauma Score (RTS) variables, PO quantifying serious injuries, and ED disposition were collected. Agreement between estimated AIS score and PO were analyzed with normal, linear weighted, and maximum kappa. Additionally, receiver operating characteristic (ROC) analysis of KTS-AIS and KTS-PO was performed. Results: A total of 1,053 patients were sampled. There was moderate agreement between AIS criteria and PO by normal (κ = 0.41), weighted (κ lin = 0.47), and maximum (κ max = 0.53) kappa. ED mortality ROC area for KTS-AIS was 0.93 (95% CI: 0.87-0.98), KTS-PO 0.89 (95%CI 0.78-1.00), SATS 0.88 (95%CI 0.79-0.97), and RTS 0.84 (95%CI 0.72-0.96). Hospital admission ROC area for KTS-AIS was 0.73 (95%CI 0.70-0.76), KTS-PO 0.79 (95%CI 0.76-0.82), SATS 0.71 (95%CI 0.68-0.74), and RTS 0.56 (95%CI 0.54-0.58). Conclusion: KTS predicted mortality and need for admission from the ED very well when early estimation of the number of serious injuries was used, regardless of method (ie, AIS criteria or physician opinion). This study provides evidence for KTS to be used as a practical and valid triage tool to predict prognosis, ED outcomes, and inform referral decision making from firstor second-level hospitals in LMICs.
doi:10.1017/s1049023x17006008 fatcat:nz35j4pjgvgwlnjojo5clhmdzu