SynthesisTrauma surgery & acute care open2020
Thefeasibility, appropriateness, and applicability of trauma scoring systems in low and middle-income countries: a systematic review.
Synthesis in Trauma surgery & acute care open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 32 citations in OpenAlex.
- A prospective study on abdominal trauma: patterns of injury, clinical presentation, organ involvement, associated injuries, and outcomes at a tertiary hospital in Mogadishu, Somalia.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Observational
- Predictive Performance of Trauma Scoring Systems for Mortality in Patients with High-Energy Trauma in the Emergency Department.Journal of clinical medicine · 2026Article
- Patient characteristics and interventions at a trauma stabilization point in Gaza- a retrospective analysis.Conflict and health · 2026Article
- Pediatric trauma management in low-resource emergency departments: from first contact to safe disposition - a narrative review.International journal of emergency medicine · 2026Review
- Performance of four scoring systems in predicting the need for massive transfusion in Iranian trauma patients.PloS one · 2026Article
- Prediction of massive transfusion and mortality in early trauma care: A retrospective analysis of scoring systems.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2025Article
- Development and Validation of a Korean Trauma and Injury Severity Score (K-TRISS) Model for Predicting Trauma Outcomes.Journal of Korean medical science · 2025Article
- Enhancing geriatric trauma mortality prediction: Modifying and assessing the Geriatric Trauma Outcome Score with net benefit and decision curve analysis.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Article
- Admission Blood Glucose Level with a Cutoff Value of 15 mmol/L Is a Reliable Predictor of Mortality in Polytraumatized Patients-a Prospective, Observational, Longitudinal Study From a North African Level One Trauma Center.Orthopedic research and reviews · 2025Article
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- The predictive value of the Kampala Trauma Score (KTS) in the outcome of multi-traumatic patients compared to the estimated Injury Severity Score (eISS).BMC emergency medicine · 2024Article
- Comparative Evaluation of Mortality Predictors in Trauma Patients: A Prospective Single-center Observational Study Assessing Injury Severity Score Revised Trauma Score Trauma and Injury Severity Score and Acute Physiology and Chronic Health Evaluation II Scores.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- The new injury severity score underestimates true injury severity in a resource-constrained setting.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2024Article
- Validation of the Pediatric Resuscitation and Trauma Outcome (PRESTO) model in injury patients in Tanzania.BMJ open · 2023Article
- Thoracic trauma in national hospital Abuja, Nigeria: The epidemiology, injury severity and initial management options.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2023Article
- Back to the basics: Clinical assessment yields robust mortality prediction and increased feasibility in low resource settings.PLOS global public health · 2023Article
- Which curve is better? A comparative analysis of trauma scoring systems in a South Asian country.Trauma surgery & acute care open · 2023Article
- The CBS test: Development, evaluation & cross-validation of a community-based injury severity scoring system in Cameroon.PLOS global public health · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAbout 5.8 million people die each year as a result of injuries, and nearly 90% of these deaths occur in low and middle-income countries (LMIC). Trauma scoring is a cornerstone of trauma quality improvement (QI) efforts, and is key to organizing and evaluating trauma services. The objective of this review was to assess the appropriateness, feasibility, and QI applicability of traditional trauma scoring systems in LMIC settings. MATERIALS AND
methodsThis systematic review searched PubMed, Scopus, CINAHL, and trauma-focused journals for articles describing the use of a standardized trauma scoring system to characterize holistic health status. Studies conducted in high-income countries (HIC) or describing scores for isolated anatomic locations were excluded. Data reporting a score's capacity to discriminate mortality, feasibility of implementation, or use for QI were extracted and synthesized.
resultsOf the 896 articles screened, 336 were included. Over half of studies (56%) reported Glasgow Coma Scale, followed by Injury Severity Score (ISS; 51%), Abbreviated Injury Scale (AIS; 24%), Revised Trauma Score (RTS; 19%), Trauma and Injury Severity Score (TRISS; 14%), and Kampala Trauma Score (7%). While ISS was overwhelmingly predictive of mortality, 12 articles reported limited feasibility of ISS and/or AIS. RTS consistently underestimated injury severity. Over a third of articles (37%) reporting TRISS assessmentsobserved mortality that was greater than that predicted by TRISS. Several articles cited limited human resources as the key challenge to feasibility.
conclusionsThe findings of this review reveal that implementing systems designed for HICs may not be relevant to the burden and resources available in LMICs. Adaptations or alternative scoring systems may be more effective. PROSPERO REGISTRATION NUMBER: CRD42017064600.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.