EVALUATION OF RAPID TRAUMA SCORING SYSTEMS FOR PREDICTING IN-HOSPITAL MORTALITY IN POLYTRAUMA PATIENTS ADMITTED TO AN EMERGENCY CENTER
DOI:
https://doi.org/10.67214/3kpwbk66Keywords:
emergency center;, GAP score;, in-hospital mortality, polytrauma, trauma scoring systemsAbstract
Abstract
Objective: Polytrauma remains a major cause of mortality and disability worldwide and requires rapid risk stratification during the early phase of emergency care. Simple physiological trauma scoring systems, such as the New Trauma Score (NTS), Glasgow Coma Scale, Age and Systolic Blood Pressure score (GAP), and Mechanism, Glasgow Coma Scale, Age and Arterial Pressure score (MGAP), may support early triage and prediction of adverse outcomes.
This study aimed to evaluate and compare the predictive accuracy of NTS, GAP, and MGAP scores for in-hospital mortality in polytrauma patients admitted to the Emergency Center.
Materials and Methods: A single-center retrospective-prospective observational cohort study was conducted at the University Emergency Surgical Center in Skopje from January 2024 to November 2025. A total of 65 polytrauma patients who met the inclusion criteria were analyzed. Demographic characteristics, mechanism of injury, Glasgow Coma Scale (GCS), systolic blood pressure, peripheral oxygen saturation, and in-hospital outcome were recorded at admission. NTS, GAP, and MGAP scores were calculated and compared for their ability to predict in-hospital mortality using receiver operating characteristic (ROC) curve analysis.
Results: Among 65 patients, 57 were male and 8 were female. Forty-nine patients survived, while 16 patients died during hospitalization. Mortality was higher among patients aged ≥60 years and among those with lower initial GCS scores.
All three scoring systems demonstrated excellent diagnostic accuracy for predicting in-hospital mortality, with area under the curve (AUC) values above 0.90. MGAP showed the highest predictive accuracy (AUC = 0.94), followed by GAP (AUC = 0.93) and NTS (AUC = 0.91).
Conclusion: NTS, GAP, and MGAP are simple and rapidly applicable scoring systems with excellent predictive accuracy for in-hospital mortality in polytrauma patients. MGAP showed the highest AUC value in this cohort, likely due to the additional inclusion of injury mechanism. However, because the performance of all three scores was excellent and closely comparable, they may all be considered useful tools for early risk stratification and triage in emergency center settings.
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References
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Data Availability Statement
The data supporting the findings of this study are available from the corresponding author upon reasonable request due to privacy and ethical restrictions related to patient data.
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