STUMBL vs TTSS in Predicting Morbidity and Mortality of Blunt Chest Trauma
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Chest X-Ray, Computed Tomography (CT) Chest (with or without contrast).
- Who it may be relevant to
- Registry conditions: Blunt Chest Wall Trauma. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
STUMBL (Study of the Management of Blunt Chest Wall Trauma) vs TTSS (Thoracic Trauma Severity Score) in Prediction of Morbidity and Mortality Rate of Blunt Chest Trauma
Overview
This study aim to compare the effectiveness of the STUMBL Score and the Thoracic Trauma Severity Score (TTSS) in predicting morbidity and mortality in patients with blunt chest wall trauma, and to evaluate which scoring system provides greater clinical utility for early risk stratification and management decisions.
Detailed description
Blunt chest wall trauma poses a clinical challenge due to its substantial contribution to morbidity and mortality, particularly following falls and vehicular accidents. Early identification of patients at high risk of complications is critical yet difficult, as delayed respiratory issues often escape initial detection. Traditional trauma scoring systems (e.g. ISS, AIS) lack specificity for isolated thoracic injury, creating a niche for more focused prognostic tools.
Two promising models have emerged: the STUMBL Score-based on age, number of rib fractures, chronic lung disease, pre-injury anticoagulant use, and oxygen saturation-is explicitly designed for blunt chest trauma prognosis. Studies report strong discriminatory performance, with development-phase c-index up to 0.96 . External validations vary: one UK cohort showed STUMBL ≥ 11 had a sensitivity of 79%, specificity of 78%, and AUC of 0.84-comparable to clinician judgment ; Italian data demonstrated excellent discrimination (C-index \~0.90) and calibration .
The Thoracic Trauma Severity Score (TTSS), initially validated in polytrauma ICU patients, yields moderate to good discrimination (c-indices 0.72-0.85) across validation studies .
Though these scores show promise, high methodological bias and limited external validations temper their widespread adoption . A direct, comparative analysis of STUMBL and TTSS within a well-defined patient cohort is thus needed.
Interventions
- Diagnostic test Chest X-Ray
First-line imaging for suspected rib fractures, hemothorax, pneumothorax, or pulmonary contusion - Diagnostic test Computed Tomography (CT) Chest (with or without contrast)
Gold standard for detecting: Rib fractures (especially multiple and posterior). Pulmonary contusions and lacerations. Hemothorax, pneumothorax, hemopericardium. Pleural or mediastinal injuries
Primary outcome measures
- To compare the predictive accuracy of the STUMBL score and TTSS in forecasting morbidity and mortality in patients with blunt chest trauma [Time frame: 14 day duration follow-up after ED admission]
Secondary outcome measures (2)
- Easy of use of STUMBL score and TTSS score in emergency clinical settings [Time frame: 14 day duration follow-up after ED admission]
- To correlate each score with specific outcomes such as pneumonia, need for mechanical ventilation, ICU admission, and in-hospital mortality [Time frame: 14 day duration follow-up after ED admission]
Eligibility criteria
Inclusion criteria
- Adult patients (≥18 years) presenting with blunt chest trauma.
- Patients who have given written informed consent to participate in the study
Exclusion criteria
- Penetrating chest injuries
- Pediatric patients (<18 years)
- Patients with incomplete records or who decline consent
- Pregnant women
- Disturbed conscious patients
- Mechanically ventilated patients
- Polytrauma patients
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Cohort
Study locations
Center list to be confirmed — check the primary protocol.
Publications
- Seok J, Cho HM, Kim HH, Kim JH, Huh U, Kim HB, Leem JH, Wang IJ. Chest Trauma Scoring Systems for Predicting Respiratory Complications in Isolated Rib Fracture. J Surg Res. 2019 Dec;244:84-90. doi: 10.1016/j.jss.2019.06.009. Epub 2019 Jul 4. PMID 31279998
- Baddam S, Burns B. Systemic Inflammatory Response Syndrome. 2025 Jun 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK547669/ PMID 31613449
- Callisto 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. PMID 35739456
Identifiers
NCT: NCT07270354 · STUMBL-TTSS-BluntChestTrauma