TraumaAVE-MREMSNCT06740409
Accuracy and External Validation of mREMS in Road Traffic Injuries
An observational study of Trauma, run by Al-Nahrain University at 1 site in Iraq.
Trial summary
The goal of this prospective observational study is to assess the accuracy and external validation of the Modified Rapid Emergency Medicine Score (mREMS) in predicting outcomes for patients with road traffic injuries (RTIs) admitted to the emergency department of a hospital in Baghdad. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Trauma
- How many people
- 292 participants
- Where
- 1 siteIraq
- Study dates
- 1 Mar 2025to 15 Jan 2026
- Phase
- Observational
- Are there results?
- None posted in the registry
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 population will consist of adult patients aged 18 years and older presenting with road traffic injuries (RTIs) to the emergency department of a hospital in Baghdad. These patients will include individuals involved in motor vehicle collisions, motorcycle accidents, pedestrian-related incidents, and other road traffic-related traumas. Participants will be recruited within 4 hours of their injury to ensure timely assessment using the Modified Rapid Emergency Medicine Score (mREMS). Patients with a wide range of injury severities, from minor injuries to life-threatening trauma, will be included to evaluate the score's predictive accuracy across diverse clinical scenarios. The population will be representative of the local demographic and traffic conditions in Baghdad, ensuring the external validation of the mREMS score in this specific context.
Who may be able to join
- Written informed consent provided by the patient or a legal representative (if the patient is unconscious or unable to provide consent).
- Patients presenting to the emergency department within 4 hours of the injury.
- Availability of complete physiological data for MREMS calculation.
- Patients whose clinical outcomes (e.g., mortality, length of hospital stay, need for intensive care) are available for follow-up and analysis.
Who cannot join
- Pregnant women, due to the potential risk involved in the study and unique considerations in trauma care.
- Patients with pre-existing severe chronic conditions (e.g., end-stage renal disease, terminal cancer) that could severely affect outcomes.
- Patients who were transferred from another hospital.
- Incomplete or missing data for mREMS parameters.
- Patients who leave against medical advice (LAMA) or are discharged before outcome data can be collected.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Can the Modified Rapid Emergency Medicine Score (mREMS) Predict Trauma Patients' Outcomes in a Deteriorated Health System After Decades of Conflict?
The goal of this prospective observational study is to assess the accuracy and external validation of the Modified Rapid Emergency Medicine Score (mREMS) in predicting outcomes for patients with road traffic injuries (RTIs) admitted to the emergency department of a hospital in Baghdad.
The main questions it aims to answer are:
Read more
How accurate is the mREMS in predicting the prognosis of road traffic injury patients? Does the mREMS provide reliable predictive value in a local context, specifically in Baghdad?
Participants will:
Be assessed using the mREMS upon admission to the emergency department. Have their clinical outcomes, including mortality, need for surgery, and length of stay, monitored throughout their hospital stay.
Read the detailed description
Road traffic injuries (RTIs) are one of the leading causes of morbidity and mortality globally, disproportionately affecting low- and middle-income countries such as Iraq. Accurate and standardized clinical tools are essential for triaging patients and improving clinical outcomes in resource-limited emergency departments. Emergency departments play a central role in the timely assessment and management of RTI patients. The Modified Rapid Emergency Medicine Score (MREMS) has emerged as a valuable tool for predicting in-hospital mortality and other critical outcomes in emergency settings. The Modified Rapid Emergency Medicine Score (mREMS) evaluates key physiological parameters, including age, heart rate, respiratory rate, oxygen saturation, mean arterial pressure, and the Glasgow Coma Scale (GCS), to provide a rapid and standardized assessment of injury severity.
Validation studies in Thailand and other regions have demonstrated mREMS's reliability in predicting in-hospital mortality and critical care needs. These studies have used performance metrics such as sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) to assess the tool's predictive accuracy. Despite these advancements, there remains a lack of validation studies in Iraq, where healthcare systems face unique challenges, including poor road safety and under-resourced emergency departments.
Previous studies emphasize the importance of adapting and validating scoring systems for specific populations. In Baghdad, RTIs are a significant public health burden, but no standardized tools like mREMS have been validated in this context. This study aims to address this gap by evaluating mREMS's performance in predicting mortality, morbidity, ICU admission, and length of hospital stay requirements in RTI patients in a Baghdad hospital. The findings will contribute to improving trauma care and inform the adaptation of standardized scoring systems in Iraq.
- Conditions
- Trauma
- Keywords
- MREMS
- Medical subject headings
- 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 7 days through discharge)
Accuracy Assessment of the modified Rapid Emergency Medicine Score (mREMS)
range from 0 to 26. A higher mREMS score indicates a greater risk of mortality.
Measured: the first 4 hours after ER admission
Secondary outcomes (2)
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
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
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Dec 2024
- Study start1 Mar 2025
- Primary completion1 Jan 2026
- Study completion15 Jan 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for 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
- 292 participants (actual)
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
- Bashar A Abdulhassan, Assistant professor of surgery, Study director, College Of Medicine - Nahrain University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06740409
- Sponsor's protocol ID
- UNCOMIRB20241214A
- Other IDs
- 017
- Acronym
- AVE-MREMS
- Status last verified
- Sep 2026
- First submitted
- 14 Dec 2024
- Last updated
- 10 Sep 2026
- Results posted
- No
- Data monitoring committee
- Yes
- Individual data sharing
- No
Publications
Cassignol A, Markarian T, Cotte J, Marmin J, Nguyen C, Cardinale M, Pauly V, Kerbaul F, Meaudre E, Bobbia X. Evaluation and Comparison of Different Prehospital Triage Scores of Trauma Patients on In-Hospital Mortality. Prehosp Emerg Care. 2019 Jul-Aug;23(4):543-550. doi: 10.1080/10903127.2018.1549627. Epub 2019 Jan 7.
PubMed 30457396Sewalt CA, Venema E, Wiegers EJA, Lecky FE, Schuit SCE, den Hartog D, Steyerberg EW, Lingsma HF. Trauma models to identify major trauma and mortality in the prehospital setting. Br J Surg. 2020 Mar;107(4):373-380. doi: 10.1002/bjs.11304. Epub 2019 Sep 10.
PubMed 31503341Miller RT, Nazir N, McDonald T, Cannon CM. The modified rapid emergency medicine score: A novel trauma triage tool to predict in-hospital mortality. Injury. 2017 Sep;48(9):1870-1877. doi: 10.1016/j.injury.2017.04.048. Epub 2017 Apr 25.
PubMed 28465003Phunghassaporn N, Sukhvibul P, Techapongsatorn S, Tansawet A. Accuracy and external validation of the modified rapid emergency medicine score in road traffic injuries in a Bangkok level I trauma center. Heliyon. 2022 Dec 10;8(12):e12225. doi: 10.1016/j.heliyon.2022.e12225. eCollection 2022 Dec.
PubMed 36568674
Study at a glance
From the registry record, last updated by the sponsor on 10 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Can the Modified Rapid Emergency Medicine Score (mREMS) Predict Trauma Patients' Outcomes in a Deteriorated Health System After Decades of Conflict?
- ClinicalTrials.gov ID
- NCT06740409
- Acronym / sponsor ID
- AVE-MREMS / UNCOMIRB20241214A
- Conditions
- Trauma
- Keywords
- MREMS
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 292 participants (actual)
- Lead sponsor
- Al-Nahrain UniversityUniversity, hospital or other
- Study start
- 1 Mar 2025 (actual)
- Primary completion
- 1 Jan 2026 (actual)
- Study completion
- 15 Jan 2026 (actual)
- First posted
- 18 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.
The goal of this prospective observational study is to assess the accuracy and external validation of the Modified Rapid Emergency Medicine Score (mREMS) in predicting outcomes for patients with road traffic injuries (RTIs) admitted to the emergency department of a hospital in Baghdad.
The main questions it aims to answer are:
How accurate is the mREMS in predicting the prognosis of road traffic injury patients? Does the mREMS provide reliable predictive value in a local context, specifically in Baghdad?
Participants will:
Be assessed using the mREMS upon admission to the emergency department. Have their clinical outcomes, including mortality, need for surgery, and length of stay, monitored throughout their hospital stay.
Detailed description
Road traffic injuries (RTIs) are one of the leading causes of morbidity and mortality globally, disproportionately affecting low- and middle-income countries such as Iraq. Accurate and standardized clinical tools are essential for triaging patients and improving clinical outcomes in resource-limited emergency departments. Emergency departments play a central role in the timely assessment and management of RTI patients. The Modified Rapid Emergency Medicine Score (MREMS) has emerged as a valuable tool for predicting in-hospital mortality and other critical outcomes in emergency settings. The Modified Rapid Emergency Medicine Score (mREMS) evaluates key physiological parameters, including age, heart rate, respiratory rate, oxygen saturation, mean arterial pressure, and the Glasgow Coma Scale (GCS), to provide a rapid and standardized assessment of injury severity.
Validation studies in Thailand and other regions have demonstrated mREMS's reliability in predicting in-hospital mortality and critical care needs. These studies have used performance metrics such as sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) to assess the tool's predictive accuracy. Despite these advancements, there remains a lack of validation studies in Iraq, where healthcare systems face unique challenges, including poor road safety and under-resourced emergency departments.
Previous studies emphasize the importance of adapting and validating scoring systems for specific populations. In Baghdad, RTIs are a significant public health burden, but no standardized tools like mREMS have been validated in this context. This study aims to address this gap by evaluating mREMS's performance in predicting mortality, morbidity, ICU admission, and length of hospital stay requirements in RTI patients in a Baghdad hospital. The findings will contribute to improving trauma care and inform the adaptation of standardized scoring systems 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 population will consist of adult patients aged 18 years and older presenting with road traffic injuries (RTIs) to the emergency department of a hospital in Baghdad. These patients will include individuals involved in motor vehicle collisions, motorcycle accidents, pedestrian-related incidents, and other road traffic-related traumas. Participants will be recruited within 4 hours of their injury to ensure timely assessment using the Modified Rapid Emergency Medicine Score (mREMS). Patients with a wide range of injury severities, from minor injuries to life-threatening trauma, will be included to evaluate the score's predictive accuracy across diverse clinical scenarios. The population will be representative of the local demographic and traffic conditions in Baghdad, ensuring the external validation of the mREMS score in this specific context.
Key inclusion criteria (4 listed)
- Written informed consent provided by the patient or a legal representative (if the patient is unconscious or unable to provide consent).
- Patients presenting to the emergency department within 4 hours of the injury.
- Availability of complete physiological data for MREMS calculation.
- Patients whose clinical outcomes (e.g., mortality, length of hospital stay, need for intensive care) are available for follow-up and analysis.
Key exclusion criteria (5 listed)
- Pregnant women, due to the potential risk involved in the study and unique considerations in trauma care.
- Patients with pre-existing severe chronic conditions (e.g., end-stage renal disease, terminal cancer) that could severely affect outcomes.
- Patients who were transferred from another hospital.
- Incomplete or missing data for mREMS parameters.
- Patients who leave against medical advice (LAMA) or are discharged before outcome data can be collected.
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 7 days through discharge)
Mortality (death) during hospitalization.
Accuracy Assessment of the modified Rapid Emergency Medicine Score (mREMS)
Time frame: the first 4 hours after ER admission
range from 0 to 26. A higher mREMS score indicates a greater risk of mortality.
2 secondary outcomes
Length of Hospitalization
Time frame: Up to discharge, an average of 7 days
Need for ICU Admission
Time frame: Up to discharge, an average of 7 days
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Sep 2026.
- Background: PubMed 30457396Cassignol A, Markarian T, Cotte J, Marmin J, Nguyen C, Cardinale M, Pauly V, Kerbaul F, Meaudre E, Bobbia X. Evaluation and Comparison of Different Prehospital Triage Scores of Trauma Patients on In-Hospital Mortality. Prehosp Emerg Care. 2019 Jul-Aug;23(4):543-550. doi: 10.1080/10903127.2018.1549627. Epub 2019 Jan 7.
- Background: PubMed 31503341Sewalt CA, Venema E, Wiegers EJA, Lecky FE, Schuit SCE, den Hartog D, Steyerberg EW, Lingsma HF. Trauma models to identify major trauma and mortality in the prehospital setting. Br J Surg. 2020 Mar;107(4):373-380. doi: 10.1002/bjs.11304. Epub 2019 Sep 10.
- Results publication: PubMed 28465003Miller RT, Nazir N, McDonald T, Cannon CM. The modified rapid emergency medicine score: A novel trauma triage tool to predict in-hospital mortality. Injury. 2017 Sep;48(9):1870-1877. doi: 10.1016/j.injury.2017.04.048. Epub 2017 Apr 25.
- Results publication: PubMed 36568674Phunghassaporn N, Sukhvibul P, Techapongsatorn S, Tansawet A. Accuracy and external validation of the modified rapid emergency medicine score in road traffic injuries in a Bangkok level I trauma center. Heliyon. 2022 Dec 10;8(12):e12225. doi: 10.1016/j.heliyon.2022.e12225. eCollection 2022 Dec.
- 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. This study is not recruiting at the moment.
Bashar A Abdulhassan, Assistant professor of surgery 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 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 4 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: finished, as of the sponsor's last update on 10 Sep 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. 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)). 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 NCT06740409, which also lists 4 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 10 Sep 2026.