The CBS test: Development, evaluation & cross-validation of a community-based injury severity scoring system in Cameroon

Haley Tupper, Rasheedat Oke, Catherine Juillard, Fanny Dissak-DeLon, Alain Chichom-Mefire, Mbiarikai Agbor Mbianyor, Georges Alain Etoundi-Mballa, Thompson Kinge, Louis Richard Njock, Daniel N Nkusu, Jean-Gustave Tsiagadigui, Melissa Carvalho, Mark Yost and S Ariane Christie

PLOS Global Public Health, 2023, vol. 3, issue 7, 1-14

Abstract: 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

Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pgph00:0002110

DOI: 10.1371/journal.pgph.0002110

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