Background Five million people die annually due to injuries; an increasing part is due to armed conflict in low-income and middle-income countries, demanding resolute emergency trauma care. In Afghanistan, a low-income country that has experienced conflict for over 35 years, conflict related trauma is a significant public health problem. To address this, the non-governmental organisation Médecins Sans Frontières (MSF) set up a trauma centre in Kunduz (Kunduz Trauma Centre (KTC)). MSF’s standardised emergency operating procedures include the South African Triage Scale (SATS). To date, there are few studies that assess how triage levels correspond with outcome in low-resource conflict settings
Aim This study aims to assess to what extent SATS triage levels correlated to outcomes in terms of hospital admission, intensive care unit (ICU) admission and mortality for patients treated at KTC.
Method and materials This retrospective study used routinely collected data from KTC registries. A total of 17 970 patients were included. The outcomes were hospital admission, ICU admission and mortality. The explanatory variable was triage level. Covariates including age, gender and delay to arrival were used. Logistic regression was used to study the correlation between triage level and outcomes.
Results Out of all patients seeking care, 28.7% were triaged as red or orange. The overall mortality was 0.6%. In total, 90% of those that died and 79% of ICU-admitted patients were triaged as red.
Conclusion The risk of positive and negative outcomes correlated with triage level. None of the patients triaged as green died or were admitted to the ICU whereas 90% of patients who died were triaged as red.
- emergency care systems
- emergency department
- global health
Data availability statement
Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available.
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Handling editor Ellen J Weber
Correction notice This article has been corrected since it was published. In the Results section of the Abstract 28.7% were triaged as red or orange instead of 70%.
Contributors All the authors have at some point read and revised the article. Coauthors from MSF Afghanistan have additionally been crucial in collecting all data and information. Data were analysed mainly by MGW, LLT and HLD. JvS revised the paper and supervised the entire work with the help of MT, MNe and MGW. JvS acted as the guarantor of the article.
Funding MGW, MNe and JvS were funded by a research grant (K919532243) from the National Board of Health and Welfare in Sweden.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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