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The CBS test: Development, evaluation & cross-validation of a community-based injury severity scoring system in Cameroon
Injury-related deaths overwhelmingly occur in low and middle-income countries (LMICs). Community-based injury surveillance is essential to accurately capture trauma epidemiology in LMICs, where one-third of injured individuals never present to formal care. However, community-based studies are constr...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10370767/ https://www.ncbi.nlm.nih.gov/pubmed/37494346 http://dx.doi.org/10.1371/journal.pgph.0002110 |
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author | Tupper, Haley Oke, Rasheedat Juillard, Catherine Dissak-DeLon, Fanny Chichom-Mefire, Alain Mbianyor, Mbiarikai Agbor Etoundi-Mballa, Georges Alain Kinge, Thompson Njock, Louis Richard Nkusu, Daniel N. Tsiagadigui, Jean-Gustave Carvalho, Melissa Yost, Mark Christie, S. Ariane |
author_facet | Tupper, Haley Oke, Rasheedat Juillard, Catherine Dissak-DeLon, Fanny Chichom-Mefire, Alain Mbianyor, Mbiarikai Agbor Etoundi-Mballa, Georges Alain Kinge, Thompson Njock, Louis Richard Nkusu, Daniel N. Tsiagadigui, Jean-Gustave Carvalho, Melissa Yost, Mark Christie, S. Ariane |
author_sort | Tupper, Haley |
collection | PubMed |
description | Injury-related deaths overwhelmingly occur in low and middle-income countries (LMICs). Community-based injury surveillance is essential to accurately capture trauma epidemiology in LMICs, where one-third of injured individuals never present to formal care. However, community-based studies are constrained by the lack of a validated surrogate injury severity metric. The primary objective of this bipartite study was to cross-validate a novel community-based injury severity (CBS) scoring system with previously-validated injury severity metrics using multi-center trauma registry data. A set of targeted questions to ascertain injury severity in non-medical settings–the CBS test—was iteratively developed with Cameroonian physicians and laypeople. The CBS test was first evaluated in the community-setting in a large household-based injury surveillance survey in southwest Cameroon. The CBS test was subsequently incorporated into the Cameroon Trauma Registry, a prospective multi-site national hospital-based trauma registry, and cross-validated in the hospital setting using objective injury metrics in patients presenting to four trauma hospitals. Among 8065 surveyed household members with 503 injury events, individuals with CBS indicators (CBS+) were more likely to report ongoing disability after injury compared to CBS- individuals (OR 1.9, p = 0.004), suggesting the CBS test is a promising injury severity proxy. In 9575 injured patients presenting for formal evaluation, the CBS test strongly predicted death in patients after controlling for age, sex, socioeconomic status, and injury type (OR 30.26, p<0.0001). Compared to established injury severity scoring systems, the CBS test comparably predicts mortality (AUC: 0.8029), but is more feasible to calculate in both the community and clinical contexts. The CBS test is a simple, valid surrogate metric of injury severity that can be deployed widely in community-based surveys to improve estimates of injury severity in under-resourced settings. |
format | Online Article Text |
id | pubmed-10370767 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-103707672023-07-27 The CBS test: Development, evaluation & cross-validation of a community-based injury severity scoring system in Cameroon Tupper, Haley Oke, Rasheedat Juillard, Catherine Dissak-DeLon, Fanny Chichom-Mefire, Alain Mbianyor, Mbiarikai Agbor Etoundi-Mballa, Georges Alain Kinge, Thompson Njock, Louis Richard Nkusu, Daniel N. Tsiagadigui, Jean-Gustave Carvalho, Melissa Yost, Mark Christie, S. Ariane PLOS Glob Public Health Research Article Injury-related deaths overwhelmingly occur in low and middle-income countries (LMICs). Community-based injury surveillance is essential to accurately capture trauma epidemiology in LMICs, where one-third of injured individuals never present to formal care. However, community-based studies are constrained by the lack of a validated surrogate injury severity metric. The primary objective of this bipartite study was to cross-validate a novel community-based injury severity (CBS) scoring system with previously-validated injury severity metrics using multi-center trauma registry data. A set of targeted questions to ascertain injury severity in non-medical settings–the CBS test—was iteratively developed with Cameroonian physicians and laypeople. The CBS test was first evaluated in the community-setting in a large household-based injury surveillance survey in southwest Cameroon. The CBS test was subsequently incorporated into the Cameroon Trauma Registry, a prospective multi-site national hospital-based trauma registry, and cross-validated in the hospital setting using objective injury metrics in patients presenting to four trauma hospitals. Among 8065 surveyed household members with 503 injury events, individuals with CBS indicators (CBS+) were more likely to report ongoing disability after injury compared to CBS- individuals (OR 1.9, p = 0.004), suggesting the CBS test is a promising injury severity proxy. In 9575 injured patients presenting for formal evaluation, the CBS test strongly predicted death in patients after controlling for age, sex, socioeconomic status, and injury type (OR 30.26, p<0.0001). Compared to established injury severity scoring systems, the CBS test comparably predicts mortality (AUC: 0.8029), but is more feasible to calculate in both the community and clinical contexts. The CBS test is a simple, valid surrogate metric of injury severity that can be deployed widely in community-based surveys to improve estimates of injury severity in under-resourced settings. Public Library of Science 2023-07-26 /pmc/articles/PMC10370767/ /pubmed/37494346 http://dx.doi.org/10.1371/journal.pgph.0002110 Text en © 2023 Tupper et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Tupper, Haley Oke, Rasheedat Juillard, Catherine Dissak-DeLon, Fanny Chichom-Mefire, Alain Mbianyor, Mbiarikai Agbor Etoundi-Mballa, Georges Alain Kinge, Thompson Njock, Louis Richard Nkusu, Daniel N. Tsiagadigui, Jean-Gustave Carvalho, Melissa Yost, Mark Christie, S. Ariane The CBS test: Development, evaluation & cross-validation of a community-based injury severity scoring system in Cameroon |
title | The CBS test: Development, evaluation & cross-validation of a community-based injury severity scoring system in Cameroon |
title_full | The CBS test: Development, evaluation & cross-validation of a community-based injury severity scoring system in Cameroon |
title_fullStr | The CBS test: Development, evaluation & cross-validation of a community-based injury severity scoring system in Cameroon |
title_full_unstemmed | The CBS test: Development, evaluation & cross-validation of a community-based injury severity scoring system in Cameroon |
title_short | The CBS test: Development, evaluation & cross-validation of a community-based injury severity scoring system in Cameroon |
title_sort | cbs test: development, evaluation & cross-validation of a community-based injury severity scoring system in cameroon |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10370767/ https://www.ncbi.nlm.nih.gov/pubmed/37494346 http://dx.doi.org/10.1371/journal.pgph.0002110 |
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