STUMBL vs TTSS in Predicting Morbidity and Mortality of Blunt Chest Trauma

December 5, 2025 updated by: Mohamed Emad Ahmed Swefy, Assiut University

STUMBL (Study of the Management of Blunt Chest Wall Trauma) vs TTSS (Thoracic Trauma Severity Score) in Prediction of Morbidity and Mortality Rate of Blunt Chest Trauma

This study aim to compare the effectiveness of the STUMBL Score and the Thoracic Trauma Severity Score (TTSS) in predicting morbidity and mortality in patients with blunt chest wall trauma, and to evaluate which scoring system provides greater clinical utility for early risk stratification and management decisions.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Blunt chest wall trauma poses a clinical challenge due to its substantial contribution to morbidity and mortality, particularly following falls and vehicular accidents. Early identification of patients at high risk of complications is critical yet difficult, as delayed respiratory issues often escape initial detection. Traditional trauma scoring systems (e.g. ISS, AIS) lack specificity for isolated thoracic injury, creating a niche for more focused prognostic tools.

Two promising models have emerged: the STUMBL Score-based on age, number of rib fractures, chronic lung disease, pre-injury anticoagulant use, and oxygen saturation-is explicitly designed for blunt chest trauma prognosis. Studies report strong discriminatory performance, with development-phase c-index up to 0.96 . External validations vary: one UK cohort showed STUMBL ≥ 11 had a sensitivity of 79%, specificity of 78%, and AUC of 0.84-comparable to clinician judgment ; Italian data demonstrated excellent discrimination (C-index ~0.90) and calibration .

The Thoracic Trauma Severity Score (TTSS), initially validated in polytrauma ICU patients, yields moderate to good discrimination (c-indices 0.72-0.85) across validation studies .

Though these scores show promise, high methodological bias and limited external validations temper their widespread adoption . A direct, comparative analysis of STUMBL and TTSS within a well-defined patient cohort is thus needed.

Study Type

Observational

Enrollment (Estimated)

124

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

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

The study population will consist of patients presenting with blunt chest trauma to the Emergency Department of Assiut university during the study period from October 2025 to October 2026

Description

Inclusion Criteria:

  • Adult patients (≥18 years) presenting with blunt chest trauma.
  • Patients who have given written informed consent to participate in the study

Exclusion Criteria:

  • Penetrating chest injuries
  • Pediatric patients (<18 years)
  • Patients with incomplete records or who decline consent
  • Pregnant women
  • Disturbed conscious patients
  • Mechanically ventilated patients
  • Polytrauma patients

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

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Blunt Chest Trauma group
The Blunt Chest Trauma Cohort comprises all consecutive adult patients (≥18 years) presenting with blunt chest trauma to the Emergency Department of Assiut university between October 2025 and October 2026. Patients meeting inclusion criteria will be enrolled prospectively and followed throughout their hospital stay to record clinical course and outcomes. At presentation both the STUMBL and TTSS scores will be calculated for each patient using standard definitions. The cohort will be analyzed as a single group to evaluate the predictive performance of each score for predefined outcomes (morbidity and mortality)
Diagnostic test: Chest X-Ray
First-line imaging for suspected rib fractures, hemothorax, pneumothorax, or pulmonary contusion
Diagnostic test: Computed Tomography (CT) Chest (with or without contrast)

Gold standard for detecting:

Rib fractures (especially multiple and posterior).

Pulmonary contusions and lacerations.

Hemothorax, pneumothorax, hemopericardium.

Pleural or mediastinal injuries

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
To compare the predictive accuracy of the STUMBL score and TTSS in forecasting morbidity and mortality in patients with blunt chest trauma
Time Frame: 14 day duration follow-up after ED admission
14 day duration follow-up after ED admission

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Easy of use of STUMBL score and TTSS score in emergency clinical settings
Time Frame: 14 day duration follow-up after ED admission

How measured:

Completion time measured with a stopwatch (minutes)
14 day duration follow-up after ED admission
To correlate each score with specific outcomes such as pneumonia, need for mechanical ventilation, ICU admission, and in-hospital mortality
Time Frame: 14 day duration follow-up after ED admission
14 day duration follow-up after ED admission

Collaborators and Investigators

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

Sponsor

Assiut University

Investigators

  • Principal Investigator: Jehan Ahmed Sayed, Professor of Anathesia and ICU, Assiut University
  • Study Director: Yasmin Elsayed Mohamed Elbeltagy, Lecturer of emergency medicine, Seuz canal 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)

December 30, 2025

Primary Completion (Estimated)

December 30, 2026

Study Completion (Estimated)

December 30, 2026

Study Registration Dates

First Submitted

November 20, 2025

First Submitted That Met QC Criteria

December 5, 2025

First Posted (Actual)

December 8, 2025

Study Record Updates

Last Update Posted (Actual)

December 8, 2025

Last Update Submitted That Met QC Criteria

December 5, 2025

Last Verified

December 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • STUMBL-TTSS-BluntChestTrauma

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared because the study is conducted as part of an academic thesis project. Data are limited to internal use within the research team and protected by institutional and ethical regulations

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

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.

Subscribe