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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
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.
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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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