Validation of the study of the management of blunt chest wall trauma (STUMBL) score for predicting in-hospital complications in patients with blunt chest trauma.

BACKGROUND

This study aimed to validate the Study of the Management of Blunt Chest Wall Trauma (STUMBL) score as a prognostic tool for predicting in-hospital complications in patients with blunt chest trauma admitted to a tertiary care hospital emergency department.

METHODS

A retrospective cohort study was conducted between January 2022 and January 2024. Adult patients (≥18 years) diagnosed with blunt thoracic trauma were included. Data were collected from electronic health records. Complications included pulmonary infections, pleural effusion, pneumothorax, intensive care unit (ICU) admission, and prolonged hospital stay. Discriminative performance was evaluated using receiver operating characteristic (ROC) analysis, with calculation of the area under the ROC curve (AUROC) and the area under the precision-recall curve (AUPRC).

RESULTS

A total of 536 patients were included, of whom 150 (28.0%) developed in-hospital complications. Patients with complications had significantly higher STUMBL scores (median 13 vs. 6, p<0.001). The STUMBL score demonstrated strong discriminative ability, with an AUROC of 0.934 (95% confidence interval [CI], 0.909-0.959) and an AUPRC of 0.889 (95% CI: 0.847-0.924). The optimal cutoff value identified was 20.5; for clinical applicability, this was rounded to ≥21, yielding a sensitivity of 84% and a specificity of 89%.

CONCLUSION

The STUMBL score demonstrated excellent performance in predicting in-hospital complications among patients with blunt chest trauma. Its simplicity and strong predictive value suggest it can be effectively incorporated into emergency department clinical decision-making.