COMPARATIVE EVALUATION OF FIVE TRAUMA SCORING SYSTEMS IN PREDICTING CLINICAL OUTCOMES IN EMERGENCY TRAUMA PATIENTS abdulilah.r.khamis@gmail.com

 

COMPARATIVE EVALUATION OF FIVE TRAUMA SCORING SYSTEMS IN PREDICTING CLINICAL OUTCOMES IN EMERGENCY TRAUMA PATIENTS

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Iraq

Oral only

Trauma accounts for 4.4 million deaths annually, ranking as the sixth leading global cause of death. While trauma scoring systems are internationally validated, their comparative performance remains underexplored in Iraq. This study prospectively evaluates the accuracy of multiple scores in predicting in-hospital mortality and endotracheal intubation.

This prospective observational study will be conducted from December 2024 to June 2025 in a tertiary Iraqi emergency department. Upon admission, ISS, RTS, TRISS, GAP, and REMS scores will be calculated for each patient. Their predictive performance will be evaluated using receiver operating characteristic (ROC) curve analysis.

A total of 204 trauma patients were included, with a median age of 30 years (IQR: 24). The leading injury cause among trauma patients was road traffic accidents at 51.5%, while extremities (72.1%) and the head (42.6%) were the most injured body areas. The overall mortality rate was 10.3%. Among the evaluated scoring systems, TRISS demonstrated the highest discriminatory power in predicting mortality, with an AUROC of 0.986 (95% CI: 0.962–1.000). This was closely followed by the Rapid Emergency Medicine Score (REMS) with an AUROC of 0.984 (95% CI: 0.956–1.000). For predicting endotracheal intubation, the GAP score outperformed other tools, achieving an AUROC of 0.997 (95% CI: 0.987 - 1.000).

The study demonstrated that all five scores had excellent discriminative ability for predicting in-hospital mortality, with TRISS and REMS showing particularly high accuracy. For predicting endotracheal intubation, the GAP proved to be the most reliable tool.