A comparative evaluation of the prognostic performance of MGAP and GAP trauma scores in predicting clinical outcomes in multiple trauma patients: protocol for a prospective cohort study from Baghdad, Iraq.

INTRODUCTION: Trauma remains a significant contributor to global morbidity and mortality, with low- and middle-income countries being particularly affected due to limited resources and delayed medical care. Although trauma scoring systems such as MGAP (Mechanism, Glasgow Coma Scale, Age, Arterial Pressure) and GAP (Glasgow Coma Scale, Age, Systolic Blood Pressure) can be used for rapid risk assessment, they have never been validated for use in conflict-affected regions like Iraq. This study assesses the prognostic accuracy of MGAP and GAP in predicting in-hospital mortality, intensive care unit admission and surgical intervention in multiple trauma cases from Iraq.

METHODS AND ANALYSIS: A prospective observational cohort study is set to take place at Al-Kadhimiya Teaching Hospital in Baghdad, running from April 2025 to March 2027. This study will include patients aged 16 and older who experience multiple trauma within 6 hours of the event. Estimated sample size of 522 participants. Demographic information, mechanism of injury, vital signs and clinical outcomes as a result of accidents will be collected. The MGAP and GAP scoring systems will be used and their results will subsequently be compared using receiver operating characteristic curve analysis. This will involve assessing the area under the curve to evaluate the predictive performance of the scores. The significant threshold will be set at p<0.05.

ETHICS AND DISSEMINATION: The study was approved by the Research Ethics Committee of the College of Medicine, Al-Nahrain University (Approval No. UNCOMIRB20250383), with approval valid from 7 March 2025 to 7 March 2027. Written and verbal informed consent was obtained from all participants prior to enrolment.

TRIAL REGISTRATION NUMBER: NCT06732791.