Comparative Analysis of Trauma Scoring Systems Across Body Regions in Polytraumatized Patients: Outcomes from Tanta University Hospitals

Abstract Background: Trauma remains a leading cause of morbidity and mortality, necessitating the use of trauma scoring systems to assess injury severity, guide clinical management, and predict patient outcomes. Various trauma scoring models exist, but their accuracy in predicting mortality among polytraumatized patients remains debated. This study aimed to evaluate and compare the predictive accuracy of different trauma scoring systems in polytraumatized patients with injuries across multiple anatomical regions admitted to Tanta University Hospitals. The study further explored the correlation between trauma scores and patient outcomes, including survival and mortality. Methods: A prospective study was conducted on 300 polytrauma patients admitted between December 2024 and May 2025. Patients were evaluated using multiple trauma scoring systems, including the Injury Severity Score (ISS), Abbreviated Injury Scale (AIS), Revised Trauma Score (RTS), Trauma and Injury Severity Score (TRISS), and Kampala Trauma Score (KTS). Physiological parameters such as heart rate, respiratory rate, blood pressure, and capillary refill time were recorded. The predictive performance of these scoring systems was assessed using regression analysis and Receiver Operating Characteristic (ROC) curve analysis. Results: The majority of the study population (79.67%) were male, with a mean age of 32.87 ± 12.06 years. Falls from heights (24%) and road traffic collisions (23%) were the leading causes of polytrauma. Among the trauma scores, TRISS (AUC = 0.99), RTS (AUC = 0.99), and Glasgow Coma Scale (GCS) (AUC = 0.99) demonstrated the highest predictive accuracy for mortality, while ISS showed poor performance (AUC = 0.18). Regression analysis confirmed that TRISS had the strongest predictive value for survival, followed by RTS and GCS, whereas ISS and KTS were less reliable predictors. Conclusion: TRISS, RTS, and GCS demonstrated the highest predictive accuracy for mortality (AUC = 0.99), whereas ISS showed limited predictive ability (AUC = 0.18). Our findings highlight the critical role of integrating physiological parameters in trauma scoring for improved clinical decision-making.