An observational study in Chest Trauma, sponsored by Al-Nahrain University. Recruiting at 1 site in Iraq. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-03-04.
Sponsored by Al-Nahrain University · Observational
This prospective observational study aims to validate the STUMBL score for risk stratification in emergency department patients with blunt thoracic trauma in Iraq. The main questions it seeks to answer are:
How accurately does the STUMBL score predict mortality and critical outcomes such as ICU admission or advanced interventions? How well does the score stratify patients by injury severity in a resource-limited setting? Are there demographic or clinical factors that influence the score's predictive performance?
Participants will:
Be assessed using the STUMBL score upon arrival at the emergency department to predict risk levels.
Have demographic and clinical data, including age, gender, injury mechanism, comorbidities, and length of hospital stay, collected to explore potential associations with outcomes.
Blunt thoracic trauma (BTT) is a significant cause of morbidity and mortality in emergency department (ED) patients worldwide. The complexity of BTT management arises from the diverse range of injuries that can occur, including rib fractures, pneumothorax, and hemothorax, which can lead to life-threatening complications if not promptly identified and treated. Studies indicate that the rise in mortality and long-term morbidity can be clearly linked to the number of rib fractures sustained. Road traffic collisions are the predominant cause of major blunt injury. BTT is more common, with relative incidence being estimated at 72-83.5% versus penetrating trauma at 16.5-28%. In emergency settings, timely and accurate assessment of patients with blunt thoracic injuries is crucial for optimizing outcomes. Thereby, there is a need for valid systems that can be effectively utilized in emergency departments to enhance clinical decision-making in a short-term manner.
The STUMBL (STUdy of the Management of BLunt chest wall trauma) score was developed to assist in clinical decision-making for patients with blunt chest wall trauma. This model includes five risk factors: patient age, the number of rib fractures, chronic lung disease, pre-injury use of anticoagulants, and oxygen saturation levels. Unlike other scoring systems that focus solely on anatomical variables and age, the STUMBL score uniquely incorporates clinical variables such as chronic lung disease and anticoagulation. A huge benefit of the STUMBL score is that these variables are all routinely measured in the ED. The score has reached a sensitivity of 80%, a specificity of 96%, a positive predictive value (PPV) of 93%, and a negative predictive value (NPV) of 86% for predicting complications following blunt chest wall trauma. By integrating essential clinical parameters, the STUMBL score helps clinicians identify patients at high risk for adverse outcomes. Each patient is evaluated based on several risk factors. A final risk score of ≥11 indicates a significant risk of developing complications, and a total risk score exceeding 25 is considered sufficiently high to require admission to the intensive care unit (ICU).
The STUMBL score has shown potential across various healthcare settings. However, its validation in varied populations, especially in low-resource areas, remains limited. In the context of Iraqi EDs, the applicability of the STUMBL score has not been thoroughly investigated. As healthcare systems face challenges related to resource, training, and infrastructure limitations, the integration of evidence-based tools like the STUMBL score could significantly improve patient care. The burden of trauma is compounded by ongoing conflict and limited healthcare resources, leading to an urgent need for effective trauma management protocols. This study aims to evaluate the performance of the STUMBL score among ED patients presenting with blunt thoracic trauma in Iraq.
72 studies on the registry are indexed under Thoracic Injuries; 18 are open to participants now.
This study's planned enrollment of 188 is above the median of 150 across 32 observational studies indexed under Thoracic Injuries.
Browse Thoracic Injuries studies →Al-Nahrain University is the lead sponsor of 26 studies on the registry; 20 are open to participants now.
Counted across the registry records on this site, refreshed daily.
The study will include adult patients (18 years and older) presenting to the emergency department at Al-Kadhimiya Teaching Hospital, Baghdad, with blunt thoracic trauma. Participants will be assessed based on injury mechanisms such as motor vehicle accidents, falls, or direct impacts, along with the severity of the trauma. Both male and female patients, regardless of comorbidities, will be included to evaluate the STUMBL score's applicability across different demographics and clinical profiles.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
In hospital mortality
Mortality (death) during hospitalization.
Time frame: In-Hospital Phase (average of 10 days through discharge); Post-Discharge Follow-Up: Day 7, Day 30
Accuracy Assessment of the STUMBL score
The score ranges from 1 to 30. ≥11 is particularly significant, as it indicates a higher risk of complications.
Time frame: the first 4 hours after ER admission
Length of Hospitalization
The total duration of a patient's stay in the hospital, measured from the date of admission to the date of discharge. This includes all days spent in general wards, intensive care units (ICU), and other hospital departments as part of their treatment course.
Time frame: Up to discharge, an average of 10 days
Rate of ICU Admission
The requirement for admission to the intensive care unit (ICU) is determined by the presence of severe clinical deterioration, significant complications, or the need for advanced monitoring and life-support measures.
Time frame: Up to discharge, an average of 10 days
Rate of Participants Requiring Surgical Intervention
need for surgical intervention during a trauma patient's hospital stay.
Time frame: Up to discharge, an average of 10 days
Plan to share: No
Started Apr 2025 (actual). Primary completion is estimated for Dec 2026, 19 months after the start.
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Al-Nahrain University