Evaluating the New Trauma Score (NTS) for Improved Mortality Prediction (NTS)

March 16, 2025 updated by: Abdul-Ilah R. Khamis, Al-Nahrain University

Prospective Validation of the New Trauma Score (NTS) for Superior Prediction of Mortality Compared to the Revised Trauma Score

The goal of this prospective cohort study is to evaluate the predictive accuracy of the New Trauma Score (NTS), a modification of the Revised Trauma Score (RTS), in determining mortality outcomes among trauma patients admitted to the emergency department at Al-Kadhimiya Teaching Hospital, Iraq.

The main questions it aims to answer are:

Does the NTS provide a more accurate prediction of mortality than the RTS? Are there specific subgroups of trauma patients where the NTS demonstrates superior predictive utility compared to the RTS?

Participants will:

Be assessed using both the NTS and RTS upon admission to the emergency department.

Have their clinical outcomes, including mortality, tracked throughout their hospital stay.

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

Trauma is increasingly being a cause of mortality globally. Every year, over 45 million people suffer moderate to severe disability as a result of trauma, making them the leading cause of mortality among persons aged 18 to 29. According to the World Health Organization (WHO), road traffic injuries caused 1.25 million deaths in 2014, and trauma is predicted to become the third biggest cause of disability globally by 2030. Accurate management and time are vital factors in the treatment of traumatic patients and play a main role in determining the outcome of trauma patients. Patients with serious traumatic injuries have a significantly lower likelihood of mortality or morbidity when treated at a designated trauma center.

Trauma scoring systems are simple to inform physicians of the severity of trauma in patients and help them decide the course of trauma management. They can be used in the field to determine whether to send a patient to a trauma center before they arrive at the hospital. When a trauma patient has just arrived at the emergency department (ED), they might also be utilized for clinical decision-making. Trauma scoring systems can be used in the emergency department to prepare the patient for surgery, to call on medical staff for trauma support, and to tell the patient's family of the severity of the patient's condition at an early stage. A scoring system must be accurate, reliable, and specific to predict trauma-related death.

As a result, trauma scores could be physiological, which detail changes in vital signs and state of awareness, such as the New Trauma Score (NTS) and Revised Trauma Score (RTS), which enable early clinical assessment of patients at admission. Anatomical, which describes the extent and number of anatomical lesions, such as the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS), allowing for later clinical assessment, including imaging after initial patient stabilization, surgery, and autopsy. combined, such as Trauma and Injury Severity Score (TRISS) and KTS, which incorporate RTS and ISS. The combined trauma ratings are especially useful in assessing the prognosis after trauma. Physiological NTS and combined KTS were developed primarily for their applicability in resource-constrained environments where advanced initial evaluation for anatomical lesions using computerized tomographic (CT) scans and magnetic resonance imaging (MRI) may not be available.

The New Trauma Score (NTS) is gaining popularity as an improved measure for predicting trauma mortality. It was created as a modification of the Revised Trauma Score (RTS) to enhance accuracy and usability. Compared to RTS, NTS includes extra measures such as oxygen saturation (SpO2) instead of respiratory rate, uses the actual Glasgow Coma Scale (GCS) score rather than coded values, and revise the systolic blood pressure interval used for the code value.These changes make the score more dynamic and suitable for a wider range of trauma settings.

Recent studies have validated the effectiveness of NTS. For instance, it demonstrated superior sensitivity in predicting mortality compared to the Kampala Trauma Score II (KTS II), though KTS II showed slightly higher specificity. NTS also performed well against other tools like MGAP and GAP, highlighting its balance between simplicity and precision. These features make it particularly useful in prehospital and emergency department triage systems, where rapid and reliable decisions are critical for patient outcomes.

Study Type

Observational

Enrollment (Estimated)

177

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 Backup

Study Locations

  • Iraq
      • Baghdad, Iraq
        • College of Medicine - Al-Nahrain University
        • Principal Investigator:
          • Abdul-Ilah R. Khamis
        • Contact:
        • Sub-Investigator:
          • Ola Yaser Mohammed, Student
        • Sub-Investigator:
          • Sara J. Abotaleb, M.B.CH.B
        • Contact:
        • Sub-Investigator:
          • yousif Hameed kurmasha, Student
        • Sub-Investigator:
          • Mohammed Kamal Zubaidi, Student
        • Sub-Investigator:
          • Ahmed mohamed ragab, Student
        • Sub-Investigator:
          • Yasser F Almealawy, Student

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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

consist of trauma patients admitted to the emergency department (ED) of Al-Kadhimiya Teaching Hospital over the study period. This will include both male and female patients of various age groups who present with trauma-related injuries.

Description

Inclusion Criteria:

  • All trauma patients (including blunt, penetrating, and traumatic brain injury) admitted to the emergency department.
  • Patients presenting with varying degrees of trauma (mild to severe).
  • Patients (or their legal representatives) who provide informed consent to participate in the study.
  • Trauma patients admitted to the emergency department.
  • Patients who are assessed using both the Revised Trauma Score (RTS) and the New Trauma Score (NTS) upon admission to the emergency department.

Exclusion Criteria:

  • Patients under 18 years old.
  • Pregnant women, due to the potential complications and challenges in trauma assessment.
  • Patients who refuse to give consent to participate in the study or whose legal guardians refuse on their behalf.
  • Trauma patients transferred from other hospitals.
  • Patients with incomplete medical records or missing key data required for trauma score calculation.

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

Outcome Measure
Measure Description
Time Frame
In hospital mortality
Time Frame: In-Hospital Phase (average of 7 days through discharge); Post-Discharge Follow-Up: Day 7, Day 30
Mortality (death) during hospitalization
In-Hospital Phase (average of 7 days through discharge); Post-Discharge Follow-Up: Day 7, Day 30
Accuracy Assessment of the New Trauma Score (NTS)
Time Frame: the first 6 hours after ER admission
The New Trauma Score (NTS) ranges from 3 to 23. Higher scores indicate better physiological status and lower mortality risk.
the first 6 hours after ER admission
Accuracy Assessment of the Revised Trauma Score (RTS)
Time Frame: the first 6 hours after ER admission
The total RTS score ranges from 0 to approximately 12, with lower scores indicating more severe injuries and a higher risk of mortality.
the first 6 hours after ER admission

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Length of Hospitalization
Time Frame: Up to discharge, an average of 7 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 days
Need for ICU Admission
Time Frame: Up to discharge, an average of 7 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 days
Need for Surgical Intervention
Time Frame: Up to discharge, an average of 7 days
need for surgical intervention during a trauma patient's hospital stay.
Up to discharge, an average of 7 days

Collaborators and Investigators

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

Sponsor

Al-Nahrain University

Investigators

  • Study Director: Mohammad A. Hamdawi, Lecturer 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

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 (Estimated)

April 28, 2025

Primary Completion (Estimated)

June 10, 2025

Study Completion (Estimated)

June 20, 2025

Study Registration Dates

First Submitted

December 10, 2024

First Submitted That Met QC Criteria

December 10, 2024

First Posted (Actual)

December 13, 2024

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

March 16, 2025

Last Verified

March 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • UNCOMIRB20241210A
  • 009 (Nahrain Medical Research Collective (NMRC))

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.

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