An observational study in Chest Trauma, sponsored by Al-Nahrain University. Recruiting at 1 site in Iraq. Open to participants aged 16 Years and older. Per ClinicalTrials.gov, last updated 2026-09-17.
Sponsored by Al-Nahrain University · Observational
This prospective observational study aims to evaluate the predictive utility of the Thorax Trauma Severity Score (TTSS) in determining morbidity and mortality in patients presenting with chest trauma at a tertiary hospital in Iraq. The primary objectives of the study are:
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.
Chest trauma encompasses a wide range of injuries from small rib fractures to potentially fatal thoracic organ injury, making it a major problem in emergency medicine and trauma care. Common causes of chest trauma include motor vehicle collisions (MVCs), falls, and attacks. After head trauma and abdominal damage, chest trauma is the third most prevalent cause of death for patients with polytrauma and the second most common unintended traumatic injury. Death rates from chest trauma are the highest; in some studies, they can reach 60%. Chest trauma is responsible for 25% of mortality in patients with severe trauma. The main causes of death in these situations are frequently ascribed to hypoxia, severe bleeding, or postponed surgery. As such, prompt diagnosis and careful evaluation of the extent of chest damage are essential for enhancing patient outcomes and reducing morbidity and death.
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.
72 studies on the registry are indexed under Thoracic Injuries; 18 are open to participants now.
This study's planned enrollment of 166 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 population includes adult patients aged 16 years and older presenting with chest trauma, including both blunt and penetrating injuries, at the emergency department of a tertiary hospital in Iraq. Participants will be evaluated for injury severity using the Thorax Trauma Severity Score (TTSS), with demographic and clinical data collected to explore outcome predictors. This population represents a diverse cohort reflective of trauma patterns in a resource-limited setting.
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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.
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
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.
Cancer (malignancy)
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Accuracy Assessment of Thorax trauma severity score (TTSS) in Predicting In-Hospital Mortality
The total score ranges from 0 to 25, with higher scores indicating more severe injuries, a poorer prognosis, and an increased risk of in-hospital mortality.
Time frame: From admission to hospital discharge or death, up to 30 days
Accuracy Assessment of the Thorax Trauma Severity Score (TTSS) in Predicting the Need for ICU Admission
The TTSS ranges from 0 to 25, with higher scores reflecting more severe thoracic injuries. This outcome evaluates the score's ability to predict the requirement for ICU admission in trauma patients, with higher TTSS values expected to correlate with increased likelihood of ICU admission.
Time frame: From emergency department admission to ICU admission, hospital discharge, or in-hospital death (up to 30 days).
Accuracy Assessment of the Thorax Trauma Severity Score (TTSS) in Predicting Early Hospital Discharge
This outcome evaluates the ability of the TTSS (ranging from 0 to 25) to predict early hospital discharge in thoracic trauma patients. Lower TTSS values are hypothesized to be associated with a higher likelihood of early discharge, reflecting less severe injury.
Time frame: From hospital admission to discharge, within 72 hours (early discharge).
Accuracy Assessment of the Thorax Trauma Severity Score (TTSS) in Predicting the Need for Surgical Intervention
This outcome measures the predictive accuracy of the TTSS range (from 0 to 25) in identifying patients who require surgical management (e.g., thoracotomy, VATS, or chest wall repair) due to thoracic trauma. Higher TTSS values are expected to correlate with an increased likelihood of surgical intervention.
Time frame: From emergency department admission to surgical intervention, hospital discharge, or in-hospital death (up to 30 days).
Accuracy Assessment of the Thorax Trauma Severity Score (TTSS) in Predicting In-Hospital Morbidity
This outcome evaluates the incidence and types of complications (morbidity) experienced by patients with thoracic trauma, as predicted by the TTSS range (from 0 to 25). Higher TTSS values are expected to correlate with increased morbidity, including respiratory complications, infections, prolonged mechanical ventilation, and other trauma-related adverse events.
Time frame: From hospital admission to discharge or death, up to 30 days.
Plan to share: No
Started Oct 2025 (actual). Primary completion is estimated for May 2027, 18 months after the start.
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Al-Nahrain University