Multiple Trauma/InjuriesRTS-MGAPNCT06744985
Comparison of RTS and MGAP Scores in Predicting Outcomes of Trauma Patients
An observational study of Multiple Trauma/Injuries, run by Al-Nahrain University at 1 site in Iraq.
Trial summary
The goal of this prospective cohort study is to compare the predictive accuracy of the Revised Trauma Score (RTS) and the MGAP score in determining clinical outcomes among multiple trauma patients hospitalized at a trauma center in Iraq. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Multiple Trauma/Injuries
- How many people
- 200 participants
- Where
- 1 siteIraq
- Study dates
- 20 Jan 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: Multiple trauma patients were admitted to the trauma and emergency department at Al-Kadhimiya Teaching Hospital in Baghdad.
Who may be able to join
- Presentation to the trauma center within 6 hours of injury.
- Availability of complete clinical and demographic data for scoring using RTS and MGAP.
- Patients who consent to participate in the study or whose legal representatives provide consent.
- Capability to assess outcomes such as survival, ICU admission, and complications.
Who cannot join
- Patients who expired before scoring or evaluation
- Missing or unreliable medical data for RTS or MGAP score calculations.
- Transfers from other facilities with interventions that could impact RTS or MGAP reliability.
- Pregnant patients, due to the unique considerations of trauma in pregnancy.
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
Bashar A Abdulhassan, Assistant professor of surgery, +964 773 129 9483, Basharabass@nahrainuniv.edu.iq
Abdulillah R. Khamees
About this study
Official title: Mortality Prediction in Multiple Trauma Patients: A Comparison of the Revised Trauma Score and MGAP Score at a Trauma Center
The goal of this prospective cohort study is to compare the predictive accuracy of the Revised Trauma Score (RTS) and the MGAP score in determining clinical outcomes among multiple trauma patients hospitalized at a trauma center in Iraq.
The main questions it aims to answer are:
Which score, RTS or MGAP, provides a more accurate prediction of clinical outcomes, including mortality? Are there specific subgroups of trauma patients where one scoring system outperforms the other?
Participants will:
Be assessed using both the RTS and MGAP scores upon admission. Have their clinical outcomes, including mortality and other relevant indicators, monitored throughout their hospital stay.
Read the detailed description
Trauma is one of the top four causes of mortality in developing countries and the second leading cause of death among the youth in these countries, as well as being the primary cause of year of life lost (YLL). Trauma represents a significant public health issue all over the world. With the progress of scientific and technological advancements and the industrialization of societies over the past century, trauma and its associated complications have emerged as the leading contributors to mortality and disability among individuals aged 1 to 44. Trauma represents a time-sensitive condition. Proper and effective management of trauma patients in both pre-hospital and hospital settings contributes to reducing mortality and preventing complications. The primary objectives in managing trauma patients include the rapid assessment of critically ill individuals, establishing treatment priorities, and delivering suitable care services.
Throughout the years, the rates of mortality due to trauma in Iraq have varied greatly because of different conflict-related influences. At the onset of the Iraq War in 2003, the case fatality rate (CFR) stood at approximately 20.4%, but by 2017 it had dropped to around 10.1%, indicating better survival outcomes among injured individuals. A study that examined combat-related fatalities from 2003 to 2006 found that although the monthly death count had doubled, the overall CFR stayed constant.
Scoring systems have been classically classified as anatomical, physiological, or combined scoring systems. The AIS, ISS, and NISS represent anatomical scoring systems that utilize various anatomical factors, such as the site and intensity of injuries. In contrast, the GCS, RTS, and PHI are physiological scoring systems that can be derived from data obtained during physical examinations. Additionally, the TRISS, NTRISS, and a TRISS are combined scoring systems that incorporate both anatomical and physiological characteristics of trauma.
The revised trauma score (RTS) is a physiological scoring system employed to assess trauma patients. Initially developed and assessed through a study involving over 2,000 individuals (10), the RTS incorporates three key physiological indicators: the Glasgow coma scale (GCS), systolic blood pressure (SBP), and respiration rate (RR). In addition, MGAP is primarily a physiological score that has been developed to predict survival outcomes in individuals experiencing trauma. Although it has been validated in research settings, it remains underutilized in low- and middle-income regions, despite its promise and practicality. The acronym MGAP represents the mechanism of injury (M), the Glasgow Coma Scale (G) score, the patient's age (A), and the systolic blood pressure (P). This score has previously been validated in France for its ability to predict 30-day mortality.
- Conditions
- Multiple Trauma/Injuries
- Keywords
- RTS, MGAP
- Medical subject headings
- Multiple Trauma, 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 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
Accuracy Assessment of the MGAP score
(mechanism, Glasgow coma scale, age, and blood pressure), Total scores can range from 3 to 29, with a higher score predicting a better prognosis.
Measured: the first 6 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 7 days
Number of Participants Requiring 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
Number of Participants Requiring 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.
- First posted20 Dec 2024
- Study start20 Jan 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 (10)Papers the sponsor has linked to this study.
- Other trials for Multiple Trauma/InjuriesStudies 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
- 200 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
- Bashar A Abdulhassan, Assistant professor of surgery, Study director, College Of Medicine - Nahrain University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06744985
- Sponsor's protocol ID
- UNCOMIRB20241213
- Other IDs
- 014
- Acronym
- RTS-MGAP
- Status last verified
- Mar 2026
- First submitted
- 12 Dec 2024
- Last updated
- 4 Mar 2026
- Results posted
- No
- Data monitoring committee
- Yes
- Individual data sharing
- No
Publications
Kelly JF, Ritenour AE, McLaughlin DF, Bagg KA, Apodaca AN, Mallak CT, Pearse L, Lawnick MM, Champion HR, Wade CE, Holcomb JB. Injury severity and causes of death from Operation Iraqi Freedom and Operation Enduring Freedom: 2003-2004 versus 2006. J Trauma. 2008 Feb;64(2 Suppl):S21-6; discussion S26-7. doi: 10.1097/TA.0b013e318160b9fb.
PubMed 18376168Heydari Farhad. The effects of multidisciplinary education for nurses and physicians on the management of patients with multiple trauma.
Heydari F, Maghami MH, Esmailian M, Zamani M. The Effect of Implementation of the Standard Clinical Practice Guideline (CPG) for Management of Multiple Trauma Patients Admitted to an Emergency Department. Adv J Emerg Med. 2017 Dec 11;2(1):e5. doi: 10.22114/AJEM.v0i0.37. eCollection 2018 Winter.
PubMed 31172068Sartorius D, Le Manach Y, David JS, Rancurel E, Smail N, Thicoipe M, Wiel E, Ricard-Hibon A, Berthier F, Gueugniaud PY, Riou B. Mechanism, glasgow coma scale, age, and arterial pressure (MGAP): a new simple prehospital triage score to predict mortality in trauma patients. Crit Care Med. 2010 Mar;38(3):831-7. doi: 10.1097/CCM.0b013e3181cc4a67.
PubMed 20068467Javali RH, Krishnamoorthy, Patil A, Srinivasarangan M, Suraj, Sriharsha. Comparison of Injury Severity Score, New Injury Severity Score, Revised Trauma Score and Trauma and Injury Severity Score for Mortality Prediction in Elderly Trauma Patients. Indian J Crit Care Med. 2019 Feb;23(2):73-77. doi: 10.5005/jp-journals-10071-23120.
PubMed 31086450Domingues CA, Coimbra R, Poggetti RS, Nogueira LS, de Sousa RMC. New Trauma and Injury Severity Score (TRISS) adjustments for survival prediction. World J Emerg Surg. 2018 Mar 6;13:12. doi: 10.1186/s13017-018-0171-8. eCollection 2018.
PubMed 29541155Soni KD, Mahindrakar S, Gupta A, Kumar S, Sagar S, Jhakal A. Comparison of ISS, NISS, and RTS score as predictor of mortality in pediatric fall. Burns Trauma. 2017 Aug 8;5:25. doi: 10.1186/s41038-017-0087-7. eCollection 2017.
PubMed 28795055Roy N, Gerdin M, Schneider E, Kizhakke Veetil DK, Khajanchi M, Kumar V, Saha ML, Dharap S, Gupta A, Tomson G, von Schreeb J. Validation of international trauma scoring systems in urban trauma centres in India. Injury. 2016 Nov;47(11):2459-2464. doi: 10.1016/j.injury.2016.09.027. Epub 2016 Sep 20.
PubMed 27667119Baghi I, Shokrgozar L, Herfatkar MR, Nezhad Ehsan K, Mohtasham Amiri Z. Mechanism of Injury, Glasgow Coma Scale, Age, and Systolic Blood Pressure: A New Trauma Scoring System to Predict Mortality in Trauma Patients. Trauma Mon. 2015 Aug;20(3):e24473. doi: 10.5812/traumamon.24473. Epub 2015 Aug 1.
PubMed 26543842Farzan 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
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
- Mortality Prediction in Multiple Trauma Patients: A Comparison of the Revised Trauma Score and MGAP Score at a Trauma Center
- ClinicalTrials.gov ID
- NCT06744985
- Acronym / sponsor ID
- RTS-MGAP / UNCOMIRB20241213
- Conditions
- Multiple Trauma/Injuries
- Keywords
- RTS, MGAP
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 200 participants (estimated)
- Lead sponsor
- Al-Nahrain UniversityUniversity, hospital or other
- Study start
- 20 Jan 2025 (actual)
- Primary completion
- 10 Dec 2026 (estimated)
- Study completion
- 20 Dec 2026 (estimated)
- First posted
- 20 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 cohort study is to compare the predictive accuracy of the Revised Trauma Score (RTS) and the MGAP score in determining clinical outcomes among multiple trauma patients hospitalized at a trauma center in Iraq.
The main questions it aims to answer are:
Which score, RTS or MGAP, provides a more accurate prediction of clinical outcomes, including mortality? Are there specific subgroups of trauma patients where one scoring system outperforms the other?
Participants will:
Be assessed using both the RTS and MGAP scores upon admission. Have their clinical outcomes, including mortality and other relevant indicators, monitored throughout their hospital stay.
Detailed description
Trauma is one of the top four causes of mortality in developing countries and the second leading cause of death among the youth in these countries, as well as being the primary cause of year of life lost (YLL). Trauma represents a significant public health issue all over the world. With the progress of scientific and technological advancements and the industrialization of societies over the past century, trauma and its associated complications have emerged as the leading contributors to mortality and disability among individuals aged 1 to 44. Trauma represents a time-sensitive condition. Proper and effective management of trauma patients in both pre-hospital and hospital settings contributes to reducing mortality and preventing complications. The primary objectives in managing trauma patients include the rapid assessment of critically ill individuals, establishing treatment priorities, and delivering suitable care services.
Throughout the years, the rates of mortality due to trauma in Iraq have varied greatly because of different conflict-related influences. At the onset of the Iraq War in 2003, the case fatality rate (CFR) stood at approximately 20.4%, but by 2017 it had dropped to around 10.1%, indicating better survival outcomes among injured individuals. A study that examined combat-related fatalities from 2003 to 2006 found that although the monthly death count had doubled, the overall CFR stayed constant.
Scoring systems have been classically classified as anatomical, physiological, or combined scoring systems. The AIS, ISS, and NISS represent anatomical scoring systems that utilize various anatomical factors, such as the site and intensity of injuries. In contrast, the GCS, RTS, and PHI are physiological scoring systems that can be derived from data obtained during physical examinations. Additionally, the TRISS, NTRISS, and a TRISS are combined scoring systems that incorporate both anatomical and physiological characteristics of trauma.
The revised trauma score (RTS) is a physiological scoring system employed to assess trauma patients. Initially developed and assessed through a study involving over 2,000 individuals (10), the RTS incorporates three key physiological indicators: the Glasgow coma scale (GCS), systolic blood pressure (SBP), and respiration rate (RR). In addition, MGAP is primarily a physiological score that has been developed to predict survival outcomes in individuals experiencing trauma. Although it has been validated in research settings, it remains underutilized in low- and middle-income regions, despite its promise and practicality. The acronym MGAP represents the mechanism of injury (M), the Glasgow Coma Scale (G) score, the patient's age (A), and the systolic blood pressure (P). This score has previously been validated in France for its ability to predict 30-day mortality.
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
- Multiple trauma patients were admitted to the trauma and emergency department at Al-Kadhimiya Teaching Hospital in Baghdad.
Key inclusion criteria (4 listed)
- Presentation to the trauma center within 6 hours of injury.
- Availability of complete clinical and demographic data for scoring using RTS and MGAP.
- Patients who consent to participate in the study or whose legal representatives provide consent.
- Capability to assess outcomes such as survival, ICU admission, and complications.
Key exclusion criteria (4 listed)
- Patients who expired before scoring or evaluation
- Missing or unreliable medical data for RTS or MGAP score calculations.
- Transfers from other facilities with interventions that could impact RTS or MGAP reliability.
- Pregnant patients, due to the unique considerations of trauma in pregnancy.
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 Revised Trauma Score (RTS)
Time frame: the first 6 hours after ER admission
The total RTS score ranges from 0 to approximately 12, with lower scores indicating more severe injuries and a higher risk of mortality.
Accuracy Assessment of the MGAP score
Time frame: the first 6 hours after ER admission
(mechanism, Glasgow coma scale, age, and blood pressure), Total scores can range from 3 to 29, with a higher score predicting a better prognosis.
3 secondary outcomes
Length of Hospitalization
Time frame: Up to discharge, an average of 7 days
Number of Participants Requiring ICU Admission
Time frame: Up to discharge, an average of 7 days
Number of Participants Requiring Surgical Intervention
Time frame: Up to discharge, an average of 7 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 18376168Kelly JF, Ritenour AE, McLaughlin DF, Bagg KA, Apodaca AN, Mallak CT, Pearse L, Lawnick MM, Champion HR, Wade CE, Holcomb JB. Injury severity and causes of death from Operation Iraqi Freedom and Operation Enduring Freedom: 2003-2004 versus 2006. J Trauma. 2008 Feb;64(2 Suppl):S21-6; discussion S26-7. doi: 10.1097/TA.0b013e318160b9fb.
- BackgroundHeydari Farhad. The effects of multidisciplinary education for nurses and physicians on the management of patients with multiple trauma.
- Background: PubMed 31172068Heydari F, Maghami MH, Esmailian M, Zamani M. The Effect of Implementation of the Standard Clinical Practice Guideline (CPG) for Management of Multiple Trauma Patients Admitted to an Emergency Department. Adv J Emerg Med. 2017 Dec 11;2(1):e5. doi: 10.22114/AJEM.v0i0.37. eCollection 2018 Winter.
- Results publication: PubMed 20068467Sartorius D, Le Manach Y, David JS, Rancurel E, Smail N, Thicoipe M, Wiel E, Ricard-Hibon A, Berthier F, Gueugniaud PY, Riou B. Mechanism, glasgow coma scale, age, and arterial pressure (MGAP): a new simple prehospital triage score to predict mortality in trauma patients. Crit Care Med. 2010 Mar;38(3):831-7. doi: 10.1097/CCM.0b013e3181cc4a67.
- Results publication: PubMed 31086450Javali RH, Krishnamoorthy, Patil A, Srinivasarangan M, Suraj, Sriharsha. Comparison of Injury Severity Score, New Injury Severity Score, Revised Trauma Score and Trauma and Injury Severity Score for Mortality Prediction in Elderly Trauma Patients. Indian J Crit Care Med. 2019 Feb;23(2):73-77. doi: 10.5005/jp-journals-10071-23120.
- Results publication: PubMed 29541155Domingues CA, Coimbra R, Poggetti RS, Nogueira LS, de Sousa RMC. New Trauma and Injury Severity Score (TRISS) adjustments for survival prediction. World J Emerg Surg. 2018 Mar 6;13:12. doi: 10.1186/s13017-018-0171-8. eCollection 2018.
- Results publication: PubMed 28795055Soni KD, Mahindrakar S, Gupta A, Kumar S, Sagar S, Jhakal A. Comparison of ISS, NISS, and RTS score as predictor of mortality in pediatric fall. Burns Trauma. 2017 Aug 8;5:25. doi: 10.1186/s41038-017-0087-7. eCollection 2017.
- Results publication: PubMed 27667119Roy N, Gerdin M, Schneider E, Kizhakke Veetil DK, Khajanchi M, Kumar V, Saha ML, Dharap S, Gupta A, Tomson G, von Schreeb J. Validation of international trauma scoring systems in urban trauma centres in India. Injury. 2016 Nov;47(11):2459-2464. doi: 10.1016/j.injury.2016.09.027. Epub 2016 Sep 20.
- Results publication: PubMed 26543842Baghi I, Shokrgozar L, Herfatkar MR, Nezhad Ehsan K, Mohtasham Amiri Z. Mechanism of Injury, Glasgow Coma Scale, Age, and Systolic Blood Pressure: A New Trauma Scoring System to Predict Mortality in Trauma Patients. Trauma Mon. 2015 Aug;20(3):e24473. doi: 10.5812/traumamon.24473. Epub 2015 Aug 1.
- Results publication: PubMed 35495411Farzan 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.
- 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.
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 Multiple Trauma/Injuries, 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 4 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 (+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)). 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 NCT06744985, which also lists 10 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.