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.

STUMBL skorunun künt toraks travmalý hastalarda hastane içi komplikasyonlarý öngörmedeki geçerliliði

AMAÇ: Bu çalýþmanýn amacý, künt toraks travmasý nedeniyle üçüncü basamak bir hastanenin acil servisine baþvuran hastalarda hastane içi komplikasyonlarý öngörmede Study of the Management of Blunt Chest Wall Trauma (STUMBL) skorunun prognostik bir araç olarak geçerliliðini deðerlendirmektir.
GEREÇ VE YÖNTEM: Bu retrospektif kohort çalýþma Ocak 2022 ile Ocak 2024 tarihleri arasýnda yürütüldü. Künt toraks travmasý tanýsý alan 18 yaþ ve üzeri eriþkin hastalar çalýþmaya dahil edildi. Veriler, hastane bilgi yönetim sisteminden elde edildi. Komplikasyonlar arasýnda pulmoner enfeksiyonlar, plevral efüzyon, pnömotoraks, yoðun bakým ünitesi (YBÜ) yatýþý ve uzamýþ hastane yatýþý yer aldý. Ayýrt edici performans, alýcý iþletim karakteristiði (ROC) analizi ile deðerlendirildi; ROC eðrisi altýnda kalan alan (AUROC) ve hassasiyet–geri çaðýrma eðrisi altýnda kalan alan (AUPRC) hesaplandý. BULGULAR: Toplam 536 hasta çalýþmaya dahil edildi. Bunlarýn 150’sinde (%28.0) hastane içi komplikasyon geliþti. Komplikasyon geliþen hastalarýn STUMBL skorlarý anlamlý þekilde daha yüksekti (medyan 13’e karþý 6, p<0.001). STUMBL skoru, AUROC 0.934 (güven aralýðý [GA] %95, 0.909–0.959) ve AUPRC 0.889 (GA %95, 0.847–0.924) deðerleri ile güçlü ayýrt edici performans gösterdi. En uygun eþik deðeri ≥21 olarak belirlendi ve bu noktada duyarlýlýk %85, özgüllük %89 olarak saptandý.
SONUÇ: STUMBL skoru, künt toraks travmalý hastalarda hastane içi komplikasyonlarý öngörmede mükemmel performans göstermiþtir. Basit yapýsý ve yüksek öngörü deðeri sayesinde, acil servislerde klinik karar verme süreçlerine etkili biçimde entegre edilebilir.