Original Article A Comparison of the Kampala Trauma Score (KTS) with the Revised Trauma Score (RTS), Injury Severity Score (ISS) and the TRISS Method in a Ugandan Trauma Registry Is Equal Performance Achieved with Fewer Resources? Jana B.A. MacLeod 1 , Olive Kobusingye 2 , Chris Frost 3 , Ron Lett 2 , Fred Kirya 2 , Caroline Shulman 4 European Journal of Trauma Abstract Background: The public health significance of injuries that occur in developing countries is now recognized. In 1996, as part of the injury surveillance registry in Kam- pala, Uganda, a new score, the Kampala Trauma Score (KTS) was instituted. The KTS, developed in light of the limited resource base of sub-Saharan Africa, is a simpli- fied composite of the Revised Trauma Score (RTS) and the Injury Severity Score (ISS) and closely resembles the Trauma Score and Injury Severity Score (TRISS). Patients and Methods: The KTS was applied retrospec- tively to a cohort of prospectively accrued urban trau- ma patients with the RTS, ISS and TRISS calculated. Using ROC (receiver operating characteristics) analysis, logistic regression models and sensitivity and specifici- ty cutoff analysis, the KTS was compared to these three scores. Results: Using logistic regression models and areas under the ROC curve, the RTS proved a more robust pre- dictor of death at 2 weeks in comparison to the KTS. However, differences in screening performance were marginal (areas under the ROC curves were 87% for the RTS and 84% for the KTS) with statistical significance only reached for an improved specificity (67% vs. 47%; p < 0.001), at a fixed sensitivity of 90%. In addition, the KTS predicted hospitalization at 2 weeks more accu- rately. Conclusion: The KTS statistically performs comparably to the RTS and ISS alone as well as to the TRISS but has the added advantage of utility. Therefore, the KTS has potential as a triage tool in resource-poor and similar health care settings. Key Words Trauma registries · Severity scores · Developing countries Eur J Trauma 2003;29:392–8 DOI 10.1007/s00068-003-1277-5 Introduction It has recently been recognized that injury is of major public health importance in developing countries. Cur- rent research into the global disease trends has high- lighted this by showing that two thirds of the world’s injuries occur in developing countries [1]. In sub-Saha- ran Africa, 14.6% of the total number of deaths and 13.8% of the total number of Disability Adjusted Life 1 Department of Surgery, Emory School of Medicine, Atlanta, USA, 2 Injury Control Center, Makerere Medical School, Kampala, Uganda, 3 Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, United Kingdom, 4 Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom. Received: December 3, 2002; revision accepted: July 16, 2003. 392 European Journal of Trauma 2003 · No. 6 © Urban & Vogel