Thorax Trauma Severity Score in Chest Trauma: A Study in Iraq
NCT ID: NCT06744959
Last Updated: 2025-08-07
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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RECRUITING
166 participants
OBSERVATIONAL
2025-07-22
2026-05-10
Brief Summary
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To assess the accuracy of TTSS in predicting mortality and critical outcomes such as ICU admission and the need for advanced interventions.
To evaluate the utility of TTSS in stratifying patients based on injury severity in a resource-constrained setting.
To identify demographic and clinical factors influencing the predictive performance of TTSS.
Participants will:
Be assessed using the TTSS upon arrival at the emergency department to establish risk stratification.
Provide demographic and clinical data, including age, gender, mechanism of injury, comorbidities, and length of hospital stay, for analyzing associations with clinical outcomes.
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Detailed Description
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Correct treatment of thoracic trauma, from anticipating the need for urgent care to addressing potential sequelae, depends on an early and precise assessment of the severity level. The requirement for a precise scale in the assessment of thoracic trauma is highlighted by the fact that no scale now in use can accomplish this. Although frequently used, scales like the Trauma Injury Severity Score (TRISS) and the Injury Severity Score (ISS) are global poly-trauma measures that understate localized thoracic damage. The Lung Injury Scale and the Abbreviated Injury Scale (AIStorax) are two other thoracic measures that only use anatomical results. The presence of three or more rib fractures, especially a fracture of the first rib, has traditionally been thought to be related with increased severity. It is currently unclear how factors like age, the mechanism, and the extent of the injury relate to the emergence of pulmonary problems.
Both anatomical and functional criteria were included in the Thorax Trauma Severity Score (TTSS), which was described by Pape et al. in 2000. Using characteristics accessible during the initial examination, the scale was designed to assist emergency medical evaluation in identifying trauma patients at risk of pulmonary problems. This evaluation could be used in both primary and secondary level hospitals. The ability of this scale to predict death has recently been verified. With a score ranging from 0 to 25 points, the TTSS takes into account five important factors: age, pleural injuries, lung contusions, rib fractures, and the PaO2/FiO2 ratio.
Although the TTSS may be useful, its validity about Iraqi hospitals has not yet been fully assessed. This study attempts to close this gap by evaluating the TTSS's prognostic function in forecasting the outcomes of thoracic trauma at tertiary-level hospitals in Iraq. The study aims to ascertain the efficacy of TTSS in a community context and pinpoint precise cut-off points that could help medical professionals make well-informed choices about patient care and treatment plans.
Conditions
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Study Design
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COHORT
PROSPECTIVE
Eligibility Criteria
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Inclusion Criteria
* Patients presenting to the emergency department with thoracic trauma.
* Patients or their legal guardians must provide informed consent to participate in the study.
Exclusion Criteria
* Pregnant patients (due to specific physiological considerations not accounted for by the scoring system).
* Patients who succumb to their injuries before scoring or baseline data collection.
* chronic respiratory diseases
* malignancy and end-organ failure
* Patients with severe head injury (having extradural, subdural, subarachnoid, or intraparenchymal hemorrhage and skull bone fracture) or those requiring prior neurosurgical intervention
* patients with severe abdominal injury requiring surgical intervention like laparotomy
16 Years
ALL
No
Sponsors
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Al-Nahrain University
OTHER
Responsible Party
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Abdul-Ilah R. Khamis
Principal Investigator
Principal Investigators
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Luma K Mohammed, Assistant professor
Role: STUDY_DIRECTOR
Al-Nahrain University
Locations
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College of Medicine - Al-Nahrain University
Baghdad, , Iraq
Countries
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Central Contacts
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Facility Contacts
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References
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Moore EE, Malangoni MA, Cogbill TH, Shackford SR, Champion HR, Jurkovich GJ, McAninch JW, Trafton PG. Organ injury scaling. IV: Thoracic vascular, lung, cardiac, and diaphragm. J Trauma. 1994 Mar;36(3):299-300. No abstract available.
Rating the severity of tissue damage. I. The abbreviated scale. JAMA. 1971 Jan 11;215(2):277-80. doi: 10.1001/jama.1971.03180150059012. No abstract available.
Boyd CR, Tolson MA, Copes WS. Evaluating trauma care: the TRISS method. Trauma Score and the Injury Severity Score. J Trauma. 1987 Apr;27(4):370-8.
Bozorgi F, Mirabi A, Chabra A, Mirabi R, Hosseininejad S-M, Zaheri H. Mechanisms of traumatic injuries in multiple trauma Patients. Int J Med Invest. 2018;7:7-15
Khandhar SJ, Johnson SB, Calhoon JH. Overview of thoracic trauma in the United States. Thorac Surg Clin. 2007 Feb;17(1):1-9. doi: 10.1016/j.thorsurg.2007.02.004.
Aukema TS, Beenen LF, Hietbrink F, Leenen LP. Validation of the Thorax Trauma Severity Score for mortality and its value for the development of acute respiratory distress syndrome. Open Access Emerg Med. 2011 Aug 23;3:49-53. doi: 10.2147/OAEM.S22802. eCollection 2011.
Pape HC, Remmers D, Rice J, Ebisch M, Krettek C, Tscherne H. Appraisal of early evaluation of blunt chest trauma: development of a standardized scoring system for initial clinical decision making. J Trauma. 2000 Sep;49(3):496-504. doi: 10.1097/00005373-200009000-00018.
Wutzler S, Wafaisade A, Maegele M, Laurer H, Geiger EV, Walcher F, Barker J, Lefering R, Marzi I; Trauma Registry of DGU. Lung Organ Failure Score (LOFS): probability of severe pulmonary organ failure after multiple injuries including chest trauma. Injury. 2012 Sep;43(9):1507-12. doi: 10.1016/j.injury.2010.12.029. Epub 2011 Jan 21.
Clark GC, Schecter WP, Trunkey DD. Variables affecting outcome in blunt chest trauma: flail chest vs. pulmonary contusion. J Trauma. 1988 Mar;28(3):298-304. doi: 10.1097/00005373-198803000-00004.
Chrysou K, Halat G, Hoksch B, Schmid RA, Kocher GJ. Lessons from a large trauma center: impact of blunt chest trauma in polytrauma patients-still a relevant problem? Scand J Trauma Resusc Emerg Med. 2017 Apr 20;25(1):42. doi: 10.1186/s13049-017-0384-y.
Other Identifiers
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UNCOMIRB20241212B
Identifier Type: -
Identifier Source: org_study_id
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