Utility of the Thoracic Trauma Severity Score in Predicting Outcomes in Isolated Thoracic Injuries: A 10-year Omani...

The Thoracic Trauma Severity Score (TTSS) is a composite scoring system developed to assess injury severity and predict outcomes in thoracic trauma. This study aimed to evaluate the performance of TTSS in predicting clinical outcomes in patients with isolated thoracic trauma in Oman.

This retrospective observational study was conducted at two tertiary academic hospitals in Muscat, Oman, between January 2014 and December 2024 and included adult patients with isolated thoracic trauma. TTSS was calculated from demographic, radiological and clinical data. Its predictive performance was assessed using receiver operating characteristic analysis for mortality, intensive care unit (ICU) admission, and surgical intervention, and correlation analysis for ICU length of stay and duration of mechanical ventilation.

A total of 100 patients were included, of which most were male (77.0%), the mean age was 42.6 ± 17.3 years and the mean TTSS was 4.28 ± 3.35. TTSS showed significant discrimination for ICU admission (area under the curve [AUC] = 0.788, 95% confidence interval [CI]: 0.696-0.879; P <0.001) and was positively correlated with ICU length of stay and duration of mechanical ventilation. In contrast, TTSS showed poor discrimination for mortality (AUC = 0.643, 95% CI: 0.382-0.903; P = 0.402) and no discriminatory value for surgical intervention (AUC = 0.503, 95% CI: 0.382-0.625; P = 0.956), neither were statistically significant.

TTSS was most useful for predicting ICU-related outcomes in isolated thoracic trauma, particularly ICU admission and respiratory support requirements. Its value for mortality and surgical intervention was limited in the current cohort, likely reflecting the very low number of deaths and the lesion-specific nature of operative decision-making.