TRISS as a Predictor of Trauma Patient Outcomes (TRISS/ER)

March 3, 2026 updated by: Abdulillah R. Khamees, Al-Nahrain University

Prospective Validation of the Trauma and Injury Severity Score (TRISS) for Predicting Mortality and Major Outcomes: Bridging the Regional Evidence Gap in Trauma Outcomes Prediction From Iraq

The goal of this prospective observational study is to evaluate the predictive utility of the Trauma and Injury Severity Score (TRISS) in determining patient outcomes, including survival and mortality, among trauma patients admitted to the trauma and emergency department of Kadhimiya Educational Hospital, Iraq.

The main questions it aims to answer are:

How accurately does TRISS predict survival and mortality outcomes in trauma patients? What is the performance of TRISS in predicting secondary outcomes, such as the need for intensive care, surgical interventions, and length of hospital stay?

Participants will:

Be assessed using the TRISS score upon their admission to the emergency department.

Have their clinical outcomes, including survival, need for intensive care, surgery, and hospital stay, monitored throughout their hospitalization.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Detailed Description

Trauma is a significant cause of mortality and morbidity around the world. Approximately 10% of the burden of disease in adults is due to traumatic injuries. Trauma can lead to serious consequences, including disabilities, psychosocial burdens, and increased mortality among the actively working population. Cardiopulmonary arrest, unplanned admissions to intensive care units, and nosocomial infections are some complications faced by trauma patients admitted to trauma centers. The estimated mortality rate for hospitalized trauma patients is 11%. The in-hospital mortality rate for trauma patients who undergo cardiopulmonary resuscitation (CPR) is 92.7%. Trauma-related mortality and morbidity depend on injury severity, diagnostic delays, and the time taken to reach a medical facility.Timely evaluation, effective post-trauma care, and appropriate triage can significantly reduce long-term mortality and morbidity among trauma patients, with rapid assessment of trauma severity being crucial for the primary triage of multiple trauma patients.

Trauma scoring systems are valuable tools for quickly assessing the severity of injuries and predicting patient outcomes. By utilizing these scoring systems, healthcare providers can enhance the organization of trauma patient triage, optimize resource allocation, and conduct immediate evaluations of potential complications. Several scoring systems have been developed to assess trauma cases. These trauma scores are classified into three categories: anatomical (such as the Abbreviated Injury Scale and Injury Severity Score), physiological (like the Revised Trauma Score), and combined (such as the Trauma and Injury Severity Score). Physiological scores can be determined during the initial clinical assessment of the patient, while anatomical scoring can be performed later after the patient has been stabilized. This makes it easier to stratify trauma patients effectively. On the other hand, combined scores that include both anatomical and physiological criteria are more useful for patient prognosis. One such combined score is the Trauma and Injury Severity Score (TRISS), which was designed by the Major Trauma Outcome Study (MTOS) in the United States to predict the outcome in polytrauma patients and includes the Injury Severity Score (ISS) and Revised Trauma Score (RTS).

Trauma is thus now a significant health challenge in Iraq. Through the long fight in Iraq, more and more people are experiencing violence-related injuries, such as from firearms and attacks. The work also demonstrates that violence is one of the primary determinants of public health because it leads to complications with injuries and the psychological development of the survivors in the course of their lives. The Iraqi healthcare system has documented a significant rise in RTAs (road traffic accidents), particularly since the escalation of conflict around 2013. Trauma care system is not well established, and few protocols are followed clinically, and no scientific method is well established to predict the outcome in trauma patients in Iraq. This is made worse by scarce resources, inadequate staffing and educational preparedness of medical personnel, and the overall lack of formalized trauma registry databases that could well monitor patient results. In the Iraqi context, only a few studies have demonstrated the use of different trauma scores to predict outcomes in patients with trauma.

There is a significant research gap regarding the use of trauma scoring systems, especially TRISS, in Iraq. Most studies focus on descriptive outcomes rather than evaluating global trauma scores in the unique Iraqi context. Resource limitations, inconsistent pre-hospital care, and conflict-related injuries complicate the application of these systems. The lack of standardized trauma registries and data collection further limits the ability to improve trauma care and emergency services in Iraq.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
204

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Iraq
      • Baghdad, Iraq, 10001
        • College of Medicine - Al-Nahrain University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population will consist of trauma patients presenting to the Emergency Department of Al-Kadhmia Teaching Hospital during the study period. These patients represent a diverse demographic and clinical profile, encompassing individuals with varying injury mechanisms, severities, and outcomes.

The study specifically targets patients for whom trauma scoring systems, including the Trauma and Injury Severity Score (TRISS), can be applied reliably. This includes both blunt and penetrating trauma cases.

Description

Inclusion Criteria:

  • Trauma patients admitted to the emergency department of Al-Kadhimiya Teaching Hospital.
  • Patients with adequate documentation of physiological and anatomical data are required for TRISS calculation.
  • Trauma scoring (TRISS) completed within the first 6 hours of hospital arrival to ensure timely assessment.

Exclusion Criteria:

  • Patients under 18 years, pregnant women, or those with conditions that alter standard trauma scoring or management.
  • Non-trauma cases (e.g., medical emergencies, terminal illnesses) to ensure focus on trauma-specific outcomes.
  • Patients with incomplete or missing data required for TRISS calculation.
  • Patients declared dead on arrival or those not treated in the trauma and emergency department.
  • Individuals refusing participation or withdrawing consent at any stage of the study.
  • Patients transferred to or from another facility or enrolled in other studies that might affect scoring accuracy or outcomes.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Accuracy Assessment of TRISS in Predicting In-Hospital Mortality
Time Frame: From admission to hospital discharge or death, up to 30 days.
This outcome evaluates the ability of the Trauma and Injury Severity Score (TRISS), which generates a probability of survival ranging from 0% to 100%, to predict in-hospital mortality among trauma patients. Lower TRISS survival probabilities are expected to correlate with increased observed mortality.
From admission to hospital discharge or death, up to 30 days.
Accuracy Assessment of TRISS in Predicting the Need for Intervention
Time Frame: From admission to hospital discharge or death, up to 30 days.
This outcome examines the predictive value of TRISS (range: 0-100% survival probability) in determining the likelihood of trauma patients requiring major interventions (such as surgical procedures, blood transfusion, or invasive monitoring). Lower TRISS survival probabilities are expected to correlate with increased intervention requirements.
From admission to hospital discharge or death, up to 30 days.
Accuracy Assessment of TRISS in Predicting the Need for Endotracheal Intubation
Time Frame: From emergency department admission to intubation, discharge, or in-hospital death, up to 30 days.
This outcome assesses the predictive performance of TRISS (range: 0-100% survival probability) in identifying trauma patients requiring endotracheal intubation during hospitalization. Lower TRISS survival probabilities are expected to be associated with an increased likelihood of intubation.
From emergency department admission to intubation, discharge, or in-hospital death, up to 30 days.
Accuracy Assessment of TRISS in Predicting Length of Hospitalization
Time Frame: From hospital admission to discharge, up to 30 days.
This outcome evaluates the ability of TRISS (range: 0-100% survival probability) to predict hospitalization duration. Patients with higher TRISS survival probabilities are expected to have shorter hospital stays, while those with lower probabilities are more likely to require prolonged hospitalization.
From hospital admission to discharge, up to 30 days.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Length of Hospitalization
Time Frame: Up to discharge, an average of 7-10 days
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.
Up to discharge, an average of 7-10 days
Number of Participants Requiring ICU Admission
Time Frame: Up to discharge, an average of 7-10 days
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.
Up to discharge, an average of 7-10 days
Need for Surgical Intervention
Time Frame: Up to discharge, an average of 7-10 days
need for surgical intervention during a trauma patient's hospital stay.
Up to discharge, an average of 7-10 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Al-Nahrain University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Director: Anees K Nile, Professor of general surgery, College Of Medicine - Nahrain University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 15, 2024

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
July 1, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
July 15, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 23, 2024

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 28, 2024

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
December 2, 2024

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 6, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 3, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • UNCOMIRB20241134

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Trauma, Multiple

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Cookie Settings

We use cookies to ensure that we give you the best experience on our website. For more details carefully read our Privacy and Cookies Policy. ...>>>You can change your preferences or withdraw your consent at any time by deleting the cookies from your website or computer as described in the policy. Please accept it and choose your preferences by ticking the corresponding boxes in the "Manage Settings" section below. Please carefully read our Terms of Service before you proceed with using any part of this website.
«Manage Settings