NCT07270354

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

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

• Status: Not Yet Recruiting
• Phase: —
• Study type: Observational
• Enrollment: 124 (estimated)
• Sponsor: Assiut University · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

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.

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.

Conditions

• Blunt Chest Wall Trauma

Interventions

Type	Name	Description
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

Timeline

• Start date: 2025-12-30
• Primary completion: 2026-12-30
• Completion: 2026-12-30
• First posted: 2025-12-08
• Last updated: 2025-12-08