Wounds and InjuriesTICU-SCORESNCT07848776
Evaluation of Three Trauma Mortality Scores in Adults Admitted to Intensive Care in Tunisia
An observational study of Wounds and Injuries and Mortality, run by University Tunis El Manar.
Trial summary
The goal of this retrospective observational study is to learn how well three simple trauma scores predict death during the hospital stay in adults admitted to intensive care after an injury in Tunisia. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Wounds and Injuries, Mortality, Critical Illness
- What is being tested?
- Trauma mortality prediction scores: GAP, MGAP, and T-NTS
- How many people
- 1,000 participants
- Where
- No sites listed yet
- Study dates
- 1 Oct 2026to 15 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: Adults aged 18 years or older who were physically admitted to the intensive care unit of Mohamed Tahar Maâmouri Hospital, Nabeul, Tunisia, because acute blunt or penetrating trauma, or an immediate consequence of that trauma, was the principal indication for critical care between 1 January 2018 and 31 December 2025. All consecutive potentially eligible admissions will be identified from the ICU registers and medical records. Only the first qualifying trauma episode and ICU admission per patient will be included. Eligible patients with missing score variables will remain in the eligible cohort but may not enter the common complete-case analysis
Who may be able to join
- Age 18 years or older at the earliest qualified assessment.
- Acute physical injury caused by a blunt or penetrating mechanism.
- Trauma or an immediate consequence of trauma was the principal reason for the first qualifying intensive care unit admission.
- The first qualifying intensive care unit admission occurred from 1 January 2018 through 31 December 2025, inclusive.
- The intensive care unit admission belonged to the continuous acute hospitalization following the index injury.
Who cannot join
- Age younger than 18 years.
- No physical admission to the participating intensive care unit, including death before ICU admission.
- Isolated burn, isolated inhalation injury, drowning, hanging, asphyxia, poisoning, or isolated thermal, electrical, or chemical injury without qualifying blunt or penetrating trauma.
- ICU admission for a medical condition when trauma was incidental and not the principal indication for critical care.
- Elective, reconstructive, rehabilitation, or late readmission after discharge from the acute trauma hospitalization.
- Iatrogenic injury or procedural complication without qualifying external blunt or penetrating trauma.
- Duplicate record or ICU readmission within the same trauma hospitalization.
- A later eligible trauma episode in a patient already included during the study period.
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: External Validation and Local Recalibration of GAP, MGAP, and the New Trauma Score for Triage (T-NTS) for All-Cause In-Hospital Mortality in Adult Trauma Patients Admitted to Intensive Care in Tunisia: A Retrospective Cohort Study
The goal of this retrospective observational study is to learn how well three simple trauma scores predict death during the hospital stay in adults admitted to intensive care after an injury in Tunisia. The scores are the Glasgow Coma Scale, Age, and Systolic Blood Pressure score (GAP); the Mechanism, Glasgow Coma Scale, Age, and Systolic Blood Pressure score (MGAP); and the New Trauma Score for Triage (T-NTS). Researchers will review existing medical records for admissions from 1 January 2018 through 31 December 2025. They will not assign treatment or contact participants. The main question is how accurately the three scores distinguish participants who died in the hospital from those discharged alive. Secondary analyses will examine agreement between score-based risk and observed mortality and performance for mortality by day 7 after ICU admission.
Read the detailed description
This single-centre retrospective cohort study will externally validate GAP, MGAP, and T-NTS in an ICU-selected adult trauma population at a tertiary hospital in Tunisia. All consecutive eligible adults physically admitted to the participating ICU during the fixed eight-year clinical window will be screened. Predictor values will be taken from the earliest qualified assessment after injury and before sedation, neuromuscular blockade, and tracheal intubation. The study therefore evaluates prognosis among trauma patients who reached intensive care and does not claim validation for triage of all emergency-department trauma patients.
The primary endpoint is death from any cause before live discharge from the continuous index admission to the study hospital. The primary comparison will use one common complete-case cohort with known outcome, age, mechanism, qualified Glasgow Coma Scale, systolic blood pressure, and peripheral oxygen saturation. Missing predictor values will not be imputed and will not change cohort eligibility; missingness and the flow from screened to eligible and analyzable participants will be reported.
Score discrimination will be summarized by area under the receiver operating characteristic curve with 95% confidence intervals and paired comparisons using DeLong's method. Observed mortality will be described within original score risk groups. Separate one-predictor logistic models will estimate local score-to-risk relationships, with 1,000 bootstrap resamples for internal validation. Mortality by calendar day 7 after index ICU admission will be a prespecified secondary endpoint if retained in the final signed protocol. No treatment, diagnostic procedure, or exposure is assigned by the investigators.
- Conditions
- Wounds and Injuries, Mortality, Critical Illness
- Being tested
- Trauma mortality prediction scores: GAP, MGAP, and T-NTS
- Keywords
- trauma, intensive care, hospital mortality, prognostic model, external validation, GAP, MGAP, New Trauma Score of Triage, Tunisia
- Medical subject headings
- Wounds and Injuries, Critical Illness
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Trauma mortality prediction scores: GAP, MGAP, and T-NTSOther
The Glasgow Coma Scale, Age, and Systolic Blood Pressure score (GAP); the Mechanism, Glasgow Coma Scale, Age, and Systolic Blood Pressure score (MGAP); and the New Trauma Score for Triage (T-NTS) will be calculated retrospectively using existing clinical information recorded before sedation, neuromuscular blockade, or tracheal intubation whenever available. The scores are evaluated as prognostic tools; they are not used to assign treatment or alter patient care.
| Study group | Role | What they receive |
|---|---|---|
| Adult Trauma ICU Cohort | All consecutive eligible adults admitted to the participating intensive care unit because of acute blunt or penetrating trauma between 1 January 2018 and 31 December 2025. GAP, MGAP, and the New Trauma Score for Triage (T-NTS) will be calculated retrospectively from routinely recorded clinical data. No treatment or diagnostic procedure is assigned by the investigators. Receives: Other: Trauma mortality prediction scores: GAP, MGAP, and T-NTS |
What is being measured
The primary outcome is the main question the study is designed to answer.
Discrimination of GAP, MGAP, and T-NTS for All-Cause In-Hospital Mortality
The clinical endpoint is death from any cause before live discharge from the continuous index admission to the study hospital. For each score, discrimination will be quantified by the area under the receiver operating characteristic curve (AUROC) with a 95% confidence interval in the common complete-case cohort. AUROC ranges from 0.5 (no discrimination) to 1.0 (perfect discrimination). Correlated AUROCs will be compared using DeLong's method.
Measured: From index hospital presentation to in-hospital death or live discharge during the continuous index hospitalization (expected up to 12 months)
Secondary outcomes (2)
Calibration and Local Recalibration of GAP, MGAP, and T-NTS for All-Cause In-Hospital Mortality
Observed all-cause in-hospital mortality with 95% confidence intervals will be reported within the original risk groups of each score. For each score, a one-predictor logistic model relating the original total score to mortality will estimate a local score-to-risk relationship. Internal validation of the recalibration procedure will use 1,000 bootstrap resamples.
Measured: From index hospital presentation to in-hospital death or live discharge during the continuous index hospitalization (expected up to 12 months)
Discrimination of GAP, MGAP, and T-NTS for All-Cause In-Hospital Mortality by Day 7
The clinical endpoint is death from any cause in the study hospital on or before calendar day 7 after the first qualifying ICU admission; the ICU admission date is day 0. The endpoint is derived from dates and is not an exact 168-hour measure. Discrimination of GAP, MGAP, and T-NTS will be summarized by AUROC with 95% confidence intervals; paired DeLong comparisons will be reported if the number of day-7 deaths is adequate.
Measured: From index ICU admission through calendar day 7 (ICU admission date = day 0)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Sep 2026
- Study start1 Oct 2026 (estimated)
- Primary completion15 Dec 2026 (estimated)
- Study completion15 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Wounds and 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
- Retrospective
- Enrolment
- 1,000 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University Tunis El Manar
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Sameh Ben Ahmed, University Tunis El Manar
- Investigators
- sameh ben ahmed, MD, Principal investigator, Anesthesiology and Intensive Care Unit, Mohamed Taher Maamouri Teaching Hospital Faculty of Medicine of Tunis, University Tunis El Manar Mrezga, 8000 Nabeul, Tunisia
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07848776
- Sponsor's protocol ID
- HTMM-TICU-SCORES-01
- Other IDs
- 59-2026
- Acronym
- TICU-SCORES
- Status last verified
- Sep 2026
- First submitted
- 23 Sep 2026
- Last updated
- 2 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant-level data extracted from confidential medical records will not be made publicly available. The data dictionary and statistical code may be shared with publication subject to ethics and institutional approval
Study at a glance
From the registry record, last updated by the sponsor on 2 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- External Validation and Local Recalibration of GAP, MGAP, and the New Trauma Score for Triage (T-NTS) for All-Cause In-Hospital Mortality in Adult Trauma Patients Admitted to Intensive Care in Tunisia: A Retrospective Cohort Study
- ClinicalTrials.gov ID
- NCT07848776
- Acronym / sponsor ID
- TICU-SCORES / HTMM-TICU-SCORES-01
- Conditions
- Wounds and Injuries, Mortality, Critical Illness
- Keywords
- trauma, intensive care, hospital mortality, prognostic model, external validation, GAP, MGAP, New Trauma Score of Triage
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 1,000 participants (estimated)
- Lead sponsor
- University Tunis El ManarUniversity, hospital or other
- Study start
- 1 Oct 2026 (estimated)
- Primary completion
- 15 Dec 2026 (estimated)
- Study completion
- 15 Dec 2026 (estimated)
- First posted
- 30 Sep 2026 (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 retrospective observational study is to learn how well three simple trauma scores predict death during the hospital stay in adults admitted to intensive care after an injury in Tunisia. The scores are the Glasgow Coma Scale, Age, and Systolic Blood Pressure score (GAP); the Mechanism, Glasgow Coma Scale, Age, and Systolic Blood Pressure score (MGAP); and the New Trauma Score for Triage (T-NTS). Researchers will review existing medical records for admissions from 1 January 2018 through 31 December 2025. They will not assign treatment or contact participants. The main question is how accurately the three scores distinguish participants who died in the hospital from those discharged alive. Secondary analyses will examine agreement between score-based risk and observed mortality and performance for mortality by day 7 after ICU admission.
Detailed description
This single-centre retrospective cohort study will externally validate GAP, MGAP, and T-NTS in an ICU-selected adult trauma population at a tertiary hospital in Tunisia. All consecutive eligible adults physically admitted to the participating ICU during the fixed eight-year clinical window will be screened. Predictor values will be taken from the earliest qualified assessment after injury and before sedation, neuromuscular blockade, and tracheal intubation. The study therefore evaluates prognosis among trauma patients who reached intensive care and does not claim validation for triage of all emergency-department trauma patients.
The primary endpoint is death from any cause before live discharge from the continuous index admission to the study hospital. The primary comparison will use one common complete-case cohort with known outcome, age, mechanism, qualified Glasgow Coma Scale, systolic blood pressure, and peripheral oxygen saturation. Missing predictor values will not be imputed and will not change cohort eligibility; missingness and the flow from screened to eligible and analyzable participants will be reported.
Score discrimination will be summarized by area under the receiver operating characteristic curve with 95% confidence intervals and paired comparisons using DeLong's method. Observed mortality will be described within original score risk groups. Separate one-predictor logistic models will estimate local score-to-risk relationships, with 1,000 bootstrap resamples for internal validation. Mortality by calendar day 7 after index ICU admission will be a prespecified secondary endpoint if retained in the final signed protocol. No treatment, diagnostic procedure, or exposure is assigned by the investigators.
Study design
- Observational model
- Cohort
- Time perspective
- Retrospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Adult Trauma ICU Cohort | – | Other: Trauma mortality prediction scores: GAP, MGAP, and T-NTSAll consecutive eligible adults admitted to the participating intensive care unit because of acute blunt or penetrating trauma between 1 January 2018 and 31 December 2025. GAP, MGAP, and the New Trauma Score for Triage (T-NTS) will be calculated retrospectively from routinely recorded clinical data. No treatment or diagnostic procedure is assigned by the investigators. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Adults aged 18 years or older who were physically admitted to the intensive care unit of Mohamed Tahar Maâmouri Hospital, Nabeul, Tunisia, because acute blunt or penetrating trauma, or an immediate consequence of that trauma, was the principal indication for critical care between 1 January 2018 and 31 December 2025. All consecutive potentially eligible admissions will be identified from the ICU registers and medical records. Only the first qualifying trauma episode and ICU admission per patient will be included. Eligible patients with missing score variables will remain in the eligible cohort but may not enter the common complete-case analysis
Key inclusion criteria (5 listed)
- Age 18 years or older at the earliest qualified assessment.
- Acute physical injury caused by a blunt or penetrating mechanism.
- Trauma or an immediate consequence of trauma was the principal reason for the first qualifying intensive care unit admission.
- The first qualifying intensive care unit admission occurred from 1 January 2018 through 31 December 2025, inclusive.
- The intensive care unit admission belonged to the continuous acute hospitalization following the index injury.
Key exclusion criteria (8 listed)
- Age younger than 18 years.
- No physical admission to the participating intensive care unit, including death before ICU admission.
- Isolated burn, isolated inhalation injury, drowning, hanging, asphyxia, poisoning, or isolated thermal, electrical, or chemical injury without qualifying blunt or penetrating trauma.
- ICU admission for a medical condition when trauma was incidental and not the principal indication for critical care.
- Elective, reconstructive, rehabilitation, or late readmission after discharge from the acute trauma hospitalization.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Trauma mortality prediction scores: GAP, MGAP, and T-NTSThe Glasgow Coma Scale, Age, and Systolic Blood Pressure score (GAP); the Mechanism, Glasgow Coma Scale, Age, and Systolic Blood Pressure score (MGAP); and the New Trauma Score for Triage (T-NTS) will be calculated retrospectively using existing clinical information recorded before sedation, neuromuscular blockade, or tracheal intubation whenever available. The scores are evaluated as prognostic tools; they are not used to assign treatment or alter patient care. | Other | Adult Trauma ICU Cohort |
Primary outcome
Discrimination of GAP, MGAP, and T-NTS for All-Cause In-Hospital Mortality
Time frame: From index hospital presentation to in-hospital death or live discharge during the continuous index hospitalization (expected up to 12 months)
The clinical endpoint is death from any cause before live discharge from the continuous index admission to the study hospital. For each score, discrimination will be quantified by the area under the receiver operating characteristic curve (AUROC) with a 95% confidence interval in the common complete-case cohort. AUROC ranges from 0.5 (no discrimination) to 1.0 (perfect discrimination). Correlated AUROCs will be compared using DeLong's method.
2 secondary outcomes
Calibration and Local Recalibration of GAP, MGAP, and T-NTS for All-Cause In-Hospital Mortality
Time frame: From index hospital presentation to in-hospital death or live discharge during the continuous index hospitalization (expected up to 12 months)
Discrimination of GAP, MGAP, and T-NTS for All-Cause In-Hospital Mortality by Day 7
Time frame: From index ICU admission through calendar day 7 (ICU admission date = day 0)
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 2 Oct 2026.
- Individual participant dataSharing planned: No. Individual participant-level data extracted from confidential medical records will not be made publicly available. The data dictionary and statistical code may be shared with publication subject to ethics and institutional approval
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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.
sameh ben ahmed, MD principal investigator
Anesthesiology and Intensive Care Unit, Mohamed Taher Maamouri Teaching Hospital Faculty of Medicine of Tunis, University Tunis El Manar Mrezga, 8000 Nabeul, Tunisia
Questions about this trial
What is this clinical trial studying?
An observational study of Wounds and Injuries and Mortality, run by University Tunis El Manar.
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 8 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 2 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
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 sameh ben ahmed, MD (+216 72 100 532, sameh.benahmed@fmt.utm.tn), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Discrimination of GAP, MGAP, and T-NTS for All-Cause In-Hospital Mortality (time frame: From index hospital presentation to in-hospital death or live discharge during the continuous index hospitalization (expected up to 12 months)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 2 Oct 2026.