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TraumaNTSNCT06732752

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

An observational study of Trauma, run by Al-Nahrain University at 1 site in Iraq.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

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. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Trauma
How many people
177 participants
Where
1 siteIraq
Study dates
28 Apr 2025to 20 Jun 2025
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

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.

Who may be able to join

  • 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.

Who cannot join

  • 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.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Luma K Mohammed, MBChB,FIBMS/CM contact

+964770225676

lumakmohammed@nahrainuniv.edu.iq

Iraq1 site
  • College of Medicine - Al-Nahrain University

    Baghdad

    Abdul-Ilah R. Khamis, +9647838571013, allaabed987@ced.nahrainuniv.edu.iq

    Mohammed A. Hamdawi, Lecturer of general surgery, 009647801604775, mohammedhamdawi@nahrainuniv.edu.iq

Other trials in Iraq

About this study

Official title: 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:

Read more

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.

Read the 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.

Conditions
Trauma
Keywords
RTS
Medical subject headings
Wounds and Injuries

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. In hospital mortality

    Mortality (death) during hospitalization

    Measured: In-Hospital Phase (average of 7 days through discharge); Post-Discharge Follow-Up: Day 7, Day 30

  2. Accuracy Assessment of the New Trauma Score (NTS)

    The New Trauma Score (NTS) ranges from 3 to 23. Higher scores indicate better physiological status and lower mortality risk.

    Measured: the first 6 hours after ER admission

  3. Accuracy Assessment of the Revised Trauma Score (RTS)

    The total RTS score ranges from 0 to approximately 12, with lower scores indicating more severe injuries and a higher risk of mortality.

    Measured: the first 6 hours after ER admission

Secondary outcomes (3)
  1. Length of Hospitalization

    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.

    Measured: Up to discharge, an average of 7 days

  2. Need for ICU Admission

    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.

    Measured: Up to discharge, an average of 7 days

  3. Need for Surgical Intervention

    need for surgical intervention during a trauma patient's hospital stay.

    Measured: Up to discharge, an average of 7 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Dec 2024
  2. Study start28 Apr 2025 (estimated)
  3. Primary completion10 Jun 2025 (estimated)
  4. Study completion20 Jun 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
177 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06732752
Sponsor's protocol ID
UNCOMIRB20241210A
Other IDs
009
Acronym
NTS
Status last verified
Mar 2025
First submitted
10 Dec 2024
Last updated
18 Mar 2025
Results posted
No
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Manoochehry S, Vafabin M, Bitaraf S, Amiri A. A Comparison between the Ability of Revised Trauma Score and Kampala Trauma Score in Predicting Mortality; a Meta-Analysis. Arch Acad Emerg Med. 2019 Jan 15;7(1):e6. eCollection 2019 Winter.

    PubMed 30847441
  • Indurkar SK Sr, Ghormade PS, Akhade S, Sarma B. Use of the Trauma and Injury Severity Score (TRISS) as a Predictor of Patient Outcome in Cases of Trauma Presenting in the Trauma and Emergency Department of a Tertiary Care Institute. Cureus. 2023 Jun 14;15(6):e40410. doi: 10.7759/cureus.40410. eCollection 2023 Jun.

    PubMed 37456404
  • Mehmood A, Rowther AA, Kobusingye O, Ssenyonjo H, Zia N, Hyder AA. Delays in emergency department intervention for patients with traumatic brain injury in Uganda. Trauma Surg Acute Care Open. 2021 Aug 26;6(1):e000674. doi: 10.1136/tsaco-2021-000674. eCollection 2021.

    PubMed 34527810
  • MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathens AB, Frey KP, Egleston BL, Salkever DS, Scharfstein DO. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006 Jan 26;354(4):366-78. doi: 10.1056/NEJMsa052049.

    PubMed 16436768
  • Nirula R, Maier R, Moore E, Sperry J, Gentilello L. Scoop and run to the trauma center or stay and play at the local hospital: hospital transfer's effect on mortality. J Trauma. 2010 Sep;69(3):595-9; discussion 599-601. doi: 10.1097/TA.0b013e3181ee6e32.

    PubMed 20838131
  • Bachani AM, Peden M, Gururaj G, Norton R, Hyder AA. Road Traffic Injuries. In: Mock CN, Nugent R, Kobusingye O, Smith KR, editors. Injury Prevention and Environmental Health. 3rd edition. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2017 Oct 27. Chapter 3. Available from http://www.ncbi.nlm.nih.gov/books/NBK525212/

    PubMed 30212112
  • Byass P, de Courten M, Graham WJ, Laflamme L, McCaw-Binns A, Sankoh OA, Tollman SM, Zaba B. Reflections on the global burden of disease 2010 estimates. PLoS Med. 2013;10(7):e1001477. doi: 10.1371/journal.pmed.1001477. Epub 2013 Jul 2.

    PubMed 23843748
  • van Breugel JMM, Niemeyer MJS, Houwert RM, Groenwold RHH, Leenen LPH, van Wessem KJP. Global changes in mortality rates in polytrauma patients admitted to the ICU-a systematic review. World J Emerg Surg. 2020 Sep 30;15(1):55. doi: 10.1186/s13017-020-00330-3.

    PubMed 32998744
  • Damulira J, Muhumuza J, Kabuye U, Ssebaggala G, Wilson ML, Barnighausen T, Lule H. New Trauma Score versus Kampala Trauma Score II in predicting mortality following road traffic crash: a prospective multi-center cohort study. BMC Emerg Med. 2024 Jul 29;24(1):130. doi: 10.1186/s12873-024-01048-0.

    PubMed 39075406
  • Farzan N, Foroghi Ghomi SY, Mohammadi AR. A retrospective study on evaluating GAP, MGAP, RTS and ISS trauma scoring system for the prediction of mortality among multiple trauma patients. Ann Med Surg (Lond). 2022 Mar 28;76:103536. doi: 10.1016/j.amsu.2022.103536. eCollection 2022 Apr.

    PubMed 35495411
  • Chawda MN, Hildebrand F, Pape HC, Giannoudis PV. Predicting outcome after multiple trauma: which scoring system? Injury. 2004 Apr;35(4):347-58. doi: 10.1016/S0020-1383(03)00140-2.

    PubMed 15037369
  • Jeong JH, Park YJ, Kim DH, Kim TY, Kang C, Lee SH, Lee SB, Kim SC, Lim D. The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction. BMC Surg. 2017 Jul 3;17(1):77. doi: 10.1186/s12893-017-0272-4.

    PubMed 28673278

Questions about this trial

What is this clinical trial studying?

An observational study of Trauma, run by Al-Nahrain University at 1 site in Iraq.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 18 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Iraq. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Abdul-Ilah R. Khamis (+9647838571013, allaabed987@ced.nahrainuniv.edu.iq), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

In hospital mortality (time frame: In-Hospital Phase (average of 7 days through discharge); Post-Discharge Follow-Up: Day 7, Day 30). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06732752, which also lists 12 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Mar 2025.

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