Chest TraumaSTUMBLNCT06734338
Validation of the STUMBL Score for Blunt Thoracic Trauma
An observational study of Chest Trauma, run by Al-Nahrain University at 1 site in Iraq.
Trial summary
This prospective observational study aims to validate the STUMBL score for risk stratification in emergency department patients with blunt thoracic trauma in Iraq. The main questions it seeks to answer are: How accurately does the STUMBL score predict mortality and critical outcomes such as ICU admission or advanced… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Chest Trauma
- How many people
- 188 participants
- Where
- 1 siteIraq
- Study dates
- 20 Apr 2025to 20 Dec 2026
- 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: The study will include adult patients (18 years and older) presenting to the emergency department at Al-Kadhimiya Teaching Hospital, Baghdad, with blunt thoracic trauma. Participants will be assessed based on injury mechanisms such as motor vehicle accidents, falls, or direct impacts, along with the severity of the trauma. Both male and female patients, regardless of comorbidities, will be included to evaluate the STUMBL score's applicability across different demographics and clinical profiles.
Who may be able to join
- Patients presenting to the emergency department with blunt thoracic trauma (e.g., motor vehicle accidents, falls, or direct impacts to the chest).
- Patients who present within 4 hours of sustaining the injury.
- Patients or their legal guardians must provide informed consent to participate in the study.
Who cannot join
- Patients with penetrating chest trauma (e.g., stab wounds, gunshot wounds).
- Patients with other life-threatening injuries that overshadow the thoracic trauma (e.g., head or abdominal trauma).
- Pregnant women due to potential risks related to radiation or certain diagnostic procedures.
- Pediatric patients under 18 years of age.
- Patients with a history of major thoracic surgery (e.g., prior lung or heart surgery) that may interfere with the assessment of trauma severity.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Iraq1 site, 1 recruiting
- Recruiting
College of Medicine - Al-Nahrain University
Baghdad
Yaser aamer Eisa Alhaibi, Assistant professor, 009647705051684, yaseraamer@nahrainuniv.edu.iq
Abdulillah R. Khamees Al-Mamoori
About this study
Official title: Validation of the STUMBL Score for Risk Stratification in Emergency Department Patients With Blunt Thoracic Trauma: A Prospective Observational Study in Iraq
This prospective observational study aims to validate the STUMBL score for risk stratification in emergency department patients with blunt thoracic trauma in Iraq. The main questions it seeks to answer are:
How accurately does the STUMBL score predict mortality and critical outcomes such as ICU admission or advanced interventions? How well does the score stratify patients by injury severity in a resource-limited setting? Are there demographic or clinical factors that influence the score's predictive performance?
Read more
Participants will:
Be assessed using the STUMBL score upon arrival at the emergency department to predict risk levels.
Have demographic and clinical data, including age, gender, injury mechanism, comorbidities, and length of hospital stay, collected to explore potential associations with outcomes.
Read the detailed description
Blunt thoracic trauma (BTT) is a significant cause of morbidity and mortality in emergency department (ED) patients worldwide. The complexity of BTT management arises from the diverse range of injuries that can occur, including rib fractures, pneumothorax, and hemothorax, which can lead to life-threatening complications if not promptly identified and treated. Studies indicate that the rise in mortality and long-term morbidity can be clearly linked to the number of rib fractures sustained. Road traffic collisions are the predominant cause of major blunt injury. BTT is more common, with relative incidence being estimated at 72-83.5% versus penetrating trauma at 16.5-28%. In emergency settings, timely and accurate assessment of patients with blunt thoracic injuries is crucial for optimizing outcomes. Thereby, there is a need for valid systems that can be effectively utilized in emergency departments to enhance clinical decision-making in a short-term manner.
The STUMBL (STUdy of the Management of BLunt chest wall trauma) score was developed to assist in clinical decision-making for patients with blunt chest wall trauma. This model includes five risk factors: patient age, the number of rib fractures, chronic lung disease, pre-injury use of anticoagulants, and oxygen saturation levels. Unlike other scoring systems that focus solely on anatomical variables and age, the STUMBL score uniquely incorporates clinical variables such as chronic lung disease and anticoagulation. A huge benefit of the STUMBL score is that these variables are all routinely measured in the ED. The score has reached a sensitivity of 80%, a specificity of 96%, a positive predictive value (PPV) of 93%, and a negative predictive value (NPV) of 86% for predicting complications following blunt chest wall trauma. By integrating essential clinical parameters, the STUMBL score helps clinicians identify patients at high risk for adverse outcomes. Each patient is evaluated based on several risk factors. A final risk score of ≥11 indicates a significant risk of developing complications, and a total risk score exceeding 25 is considered sufficiently high to require admission to the intensive care unit (ICU).
The STUMBL score has shown potential across various healthcare settings. However, its validation in varied populations, especially in low-resource areas, remains limited. In the context of Iraqi EDs, the applicability of the STUMBL score has not been thoroughly investigated. As healthcare systems face challenges related to resource, training, and infrastructure limitations, the integration of evidence-based tools like the STUMBL score could significantly improve patient care. The burden of trauma is compounded by ongoing conflict and limited healthcare resources, leading to an urgent need for effective trauma management protocols. This study aims to evaluate the performance of the STUMBL score among ED patients presenting with blunt thoracic trauma in Iraq.
- Conditions
- Chest Trauma
- Keywords
- STUMBL, Trauma, Chest
- Medical subject headings
- Thoracic Injuries, Wounds and Injuries
What is being measured
The primary outcome is the main question the study is designed to answer.
In hospital mortality
Mortality (death) during hospitalization.
Measured: In-Hospital Phase (average of 10 days through discharge); Post-Discharge Follow-Up: Day 7, Day 30
Accuracy Assessment of the STUMBL score
The score ranges from 1 to 30. ≥11 is particularly significant, as it indicates a higher risk of complications.
Measured: the first 4 hours after ER admission
Secondary outcomes (3)
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 10 days
Rate of 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 10 days
Rate of Participants Requiring Surgical Intervention
need for surgical intervention during a trauma patient's hospital stay.
Measured: Up to discharge, an average of 10 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Dec 2024
- Study start20 Apr 2025
- Primary completion10 Dec 2026 (estimated)
- Study completion20 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (6)Papers the sponsor has linked to this study.
- Other trials for Chest TraumaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- 188 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Al-Nahrain University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Abdulillah R. Khamees, Al-Nahrain University
- Investigators
- Yaser aamer Eisa Alhaibi, Assistant professor, Study director, College Of Medicine - Nahrain University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06734338
- Sponsor's protocol ID
- UNCOMIRB20241212
- Other IDs
- 012
- Acronym
- STUMBL
- Status last verified
- Mar 2026
- First submitted
- 11 Dec 2024
- Last updated
- 4 Mar 2026
- Results posted
- No
- Data monitoring committee
- Yes
- Individual data sharing
- No
Publications
Kelderman I, Dickhoff C, Bloemers FW, Zuidema WP. Very long-term effects of conservatively treated blunt thoracic trauma: A retrospective analysis. Injury. 2024 Apr;55(4):111460. doi: 10.1016/j.injury.2024.111460. Epub 2024 Mar 2.
PubMed 38458000Mistry RN, Moore JE. Management of blunt thoracic trauma. BJA Educ. 2022 Nov;22(11):432-439. doi: 10.1016/j.bjae.2022.08.002. Epub 2022 Oct 1. No abstract available.
PubMed 36304913Mukerji S, Tan E, May C, Micanovic C, Blakemore P, Phelps K, Melville H, Jones P. Retrospective validation of a risk stratification tool developed for the management of patients with blunt chest trauma (the STUMBL score). Emerg Med Australas. 2021 Oct;33(5):841-847. doi: 10.1111/1742-6723.13740. Epub 2021 Feb 17.
PubMed 33599054Callisto E, Costantino G, Tabner A, Kerslake D, Reed MJ. The clinical effectiveness of the STUMBL score for the management of ED patients with blunt chest trauma compared to clinical evaluation alone. Intern Emerg Med. 2022 Sep;17(6):1785-1793. doi: 10.1007/s11739-022-03001-0. Epub 2022 Jun 23.
PubMed 35739456Battle C, Cole E, Whelan R, Baker E. Scoping review of the literature to ascertain how the STUMBL Score clinical prediction model is used to manage patients with blunt chest wall trauma in emergency care. Injury. 2023 Jul;54(7):110796. doi: 10.1016/j.injury.2023.05.027. Epub 2023 May 7.
PubMed 37208252Battle C, Cole E, Carter K, Baker E. Clinical prediction models for the management of blunt chest trauma in the emergency department: a systematic review. BMC Emerg Med. 2024 Oct 12;24(1):189. doi: 10.1186/s12873-024-01107-6.
PubMed 39395934
Study at a glance
From the registry record, last updated by the sponsor on 4 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Validation of the STUMBL Score for Risk Stratification in Emergency Department Patients With Blunt Thoracic Trauma: A Prospective Observational Study in Iraq
- ClinicalTrials.gov ID
- NCT06734338
- Acronym / sponsor ID
- STUMBL / UNCOMIRB20241212
- Conditions
- Chest Trauma
- Keywords
- STUMBL, Trauma, Chest
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 188 participants (estimated)
- Lead sponsor
- Al-Nahrain UniversityUniversity, hospital or other
- Study start
- 20 Apr 2025 (actual)
- Primary completion
- 10 Dec 2026 (estimated)
- Study completion
- 20 Dec 2026 (estimated)
- First posted
- 16 Dec 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This prospective observational study aims to validate the STUMBL score for risk stratification in emergency department patients with blunt thoracic trauma in Iraq. The main questions it seeks to answer are:
How accurately does the STUMBL score predict mortality and critical outcomes such as ICU admission or advanced interventions? How well does the score stratify patients by injury severity in a resource-limited setting? Are there demographic or clinical factors that influence the score's predictive performance?
Participants will:
Be assessed using the STUMBL score upon arrival at the emergency department to predict risk levels.
Have demographic and clinical data, including age, gender, injury mechanism, comorbidities, and length of hospital stay, collected to explore potential associations with outcomes.
Detailed description
Blunt thoracic trauma (BTT) is a significant cause of morbidity and mortality in emergency department (ED) patients worldwide. The complexity of BTT management arises from the diverse range of injuries that can occur, including rib fractures, pneumothorax, and hemothorax, which can lead to life-threatening complications if not promptly identified and treated. Studies indicate that the rise in mortality and long-term morbidity can be clearly linked to the number of rib fractures sustained. Road traffic collisions are the predominant cause of major blunt injury. BTT is more common, with relative incidence being estimated at 72-83.5% versus penetrating trauma at 16.5-28%. In emergency settings, timely and accurate assessment of patients with blunt thoracic injuries is crucial for optimizing outcomes. Thereby, there is a need for valid systems that can be effectively utilized in emergency departments to enhance clinical decision-making in a short-term manner.
The STUMBL (STUdy of the Management of BLunt chest wall trauma) score was developed to assist in clinical decision-making for patients with blunt chest wall trauma. This model includes five risk factors: patient age, the number of rib fractures, chronic lung disease, pre-injury use of anticoagulants, and oxygen saturation levels. Unlike other scoring systems that focus solely on anatomical variables and age, the STUMBL score uniquely incorporates clinical variables such as chronic lung disease and anticoagulation. A huge benefit of the STUMBL score is that these variables are all routinely measured in the ED. The score has reached a sensitivity of 80%, a specificity of 96%, a positive predictive value (PPV) of 93%, and a negative predictive value (NPV) of 86% for predicting complications following blunt chest wall trauma. By integrating essential clinical parameters, the STUMBL score helps clinicians identify patients at high risk for adverse outcomes. Each patient is evaluated based on several risk factors. A final risk score of ≥11 indicates a significant risk of developing complications, and a total risk score exceeding 25 is considered sufficiently high to require admission to the intensive care unit (ICU).
The STUMBL score has shown potential across various healthcare settings. However, its validation in varied populations, especially in low-resource areas, remains limited. In the context of Iraqi EDs, the applicability of the STUMBL score has not been thoroughly investigated. As healthcare systems face challenges related to resource, training, and infrastructure limitations, the integration of evidence-based tools like the STUMBL score could significantly improve patient care. The burden of trauma is compounded by ongoing conflict and limited healthcare resources, leading to an urgent need for effective trauma management protocols. This study aims to evaluate the performance of the STUMBL score among ED patients presenting with blunt thoracic trauma in Iraq.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- The study will include adult patients (18 years and older) presenting to the emergency department at Al-Kadhimiya Teaching Hospital, Baghdad, with blunt thoracic trauma. Participants will be assessed based on injury mechanisms such as motor vehicle accidents, falls, or direct impacts, along with the severity of the trauma. Both male and female patients, regardless of comorbidities, will be included to evaluate the STUMBL score's applicability across different demographics and clinical profiles.
Key inclusion criteria (3 listed)
- Patients presenting to the emergency department with blunt thoracic trauma (e.g., motor vehicle accidents, falls, or direct impacts to the chest).
- Patients who present within 4 hours of sustaining the injury.
- Patients or their legal guardians must provide informed consent to participate in the study.
Key exclusion criteria (5 listed)
- Patients with penetrating chest trauma (e.g., stab wounds, gunshot wounds).
- Patients with other life-threatening injuries that overshadow the thoracic trauma (e.g., head or abdominal trauma).
- Pregnant women due to potential risks related to radiation or certain diagnostic procedures.
- Pediatric patients under 18 years of age.
- Patients with a history of major thoracic surgery (e.g., prior lung or heart surgery) that may interfere with the assessment of trauma severity.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
In hospital mortality
Time frame: In-Hospital Phase (average of 10 days through discharge); Post-Discharge Follow-Up: Day 7, Day 30
Mortality (death) during hospitalization.
Accuracy Assessment of the STUMBL score
Time frame: the first 4 hours after ER admission
The score ranges from 1 to 30. ≥11 is particularly significant, as it indicates a higher risk of complications.
3 secondary outcomes
Length of Hospitalization
Time frame: Up to discharge, an average of 10 days
Rate of ICU Admission
Time frame: Up to discharge, an average of 10 days
Rate of Participants Requiring Surgical Intervention
Time frame: Up to discharge, an average of 10 days
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Mar 2026.
- Background: PubMed 38458000Kelderman I, Dickhoff C, Bloemers FW, Zuidema WP. Very long-term effects of conservatively treated blunt thoracic trauma: A retrospective analysis. Injury. 2024 Apr;55(4):111460. doi: 10.1016/j.injury.2024.111460. Epub 2024 Mar 2.
- Background: PubMed 36304913Mistry RN, Moore JE. Management of blunt thoracic trauma. BJA Educ. 2022 Nov;22(11):432-439. doi: 10.1016/j.bjae.2022.08.002. Epub 2022 Oct 1. No abstract available.
- Results publication: PubMed 33599054Mukerji S, Tan E, May C, Micanovic C, Blakemore P, Phelps K, Melville H, Jones P. Retrospective validation of a risk stratification tool developed for the management of patients with blunt chest trauma (the STUMBL score). Emerg Med Australas. 2021 Oct;33(5):841-847. doi: 10.1111/1742-6723.13740. Epub 2021 Feb 17.
- Results publication: PubMed 35739456Callisto E, Costantino G, Tabner A, Kerslake D, Reed MJ. The clinical effectiveness of the STUMBL score for the management of ED patients with blunt chest trauma compared to clinical evaluation alone. Intern Emerg Med. 2022 Sep;17(6):1785-1793. doi: 10.1007/s11739-022-03001-0. Epub 2022 Jun 23.
- Results publication: PubMed 37208252Battle C, Cole E, Whelan R, Baker E. Scoping review of the literature to ascertain how the STUMBL Score clinical prediction model is used to manage patients with blunt chest wall trauma in emergency care. Injury. 2023 Jul;54(7):110796. doi: 10.1016/j.injury.2023.05.027. Epub 2023 May 7.
- Results publication: PubMed 39395934Battle C, Cole E, Carter K, Baker E. Clinical prediction models for the management of blunt chest trauma in the emergency department: a systematic review. BMC Emerg Med. 2024 Oct 12;24(1):189. doi: 10.1186/s12873-024-01107-6.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Yaser aamer Eisa Alhaibi, Assistant professor study director
College Of Medicine - Nahrain University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Chest 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 3 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: looking for participants now, as of the sponsor's last update on 4 Mar 2026. 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 Abdulillah R. Khamees Al-Mamoori (+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 10 days through discharge); Post-Discharge Follow-Up: Day 7, Day 30). The study lists 2 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 NCT06734338, which also lists 6 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 4 Mar 2026.