Background: Road traffic injury is of growing public health importance because of its
significant contribution to the global disease burden. The need to predict outcome of injuries
has led to the development of injury scores. The Kampala Trauma Score II (KTSII) now
recommended for use in resource-poor settings, has not been compared with, the New Injury
Severity Score (NISS) preferred by many authors. We compared the performance, predictive
power, sensitivity, and specificity in predicting mortality at two weeks of the KTSII and NISS in
patients involved in road traffic accidents seen on the surgical ward at Mbarara Regional
Referral Hospital (MRRH).
Methods: This prospective study conducted between June 2005 and August 2006, examined
clinical and radiological data of 173 consecutive patients admitted to the emergency surgical
ward at Mbarara Regional Referral Hospital with road traffic injuries. Only patients presenting
within 24 hours of injury and with 3 or more injuries were recruited in the study. The KTS II
and NISS scores were computed for each patient on admission. The primary outcome measure
was survival. Receiver Operating Characteristics (ROC) analysis, and logistic regression
analysis were used for comparison.
Results: The KTSII predicted mortality and discharge with AUC of 0.87 (NISS, AUC 0.89). The
KTSII was less accurate (AUC 0.65) than the NISS (AUC 0.83) in predicting long stay in the
hospital. At cut off point of 9 and below, the KTSII had sensitivity of 87% and specificity of
81% while the NISS had 96% and 78.4% respectively in predicting mortality. The KTS II
predicted long hospital stay at cut off score of 9 and below, with sensitivity of 87.5% and
specificity of 81%.
Conclusions: The KTSII is as reliable a predictive score as is the NISS. This study demonstrated
that the KTS II provides reliable objective criterion upon which injured patients can be triaged
in emergency care conditions. The KTS II may enhance the use of ambulance services and
timely transfer of the injured and its use in trauma management should be further encouraged
in resource-poor settings. In addition, the KTS II will make the documentation of the
epidemiology of trauma more feasible in resource-poor settings.
