Comparison of EMTRAS, REMS, and GAP Scores in Trauma

NCT07186777 | Recruiting DMC

• 1 other identifier: UNCOMIRB2025934
• Study Type: observational
• Target: 188
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this prospective multicenter cohort study is to evaluate and compare the predictive utility of the EMTRAS, REMS, and GAP scores in determining key outcomes among trauma patients admitted to participating hospitals in Iraq. The primary outcomes of interest include mortality, the need for endotracheal intubation, and length of hospitalization. The main questions it aims to answer are: How accurately do EMTRAS, REMS, and GAP scores predict mortality in trauma patients? How effective are these scores in predicting the need for endotracheal intubation? How well do these scores correlate with hospitalization duration in trauma patients? Participants will: Be assessed using EMTRAS, REMS, and GAP scores upon admission to the emergency department. Have their clinical outcomes, including survival, intubation requirements, and length of hospital stay, monitored throughout their hospitalization.

Conditions

Trauma Patients

Keywords

EMTRAS; REMS; GAP; Trauma

Outcome Measures

Primary Outcomes (1)

• Accuracy Assessment of EMTRAS, REMS, and GAP Scores in Predicting In-Hospital Mortality

  This outcome evaluates the ability of EMTRAS (range 0-12), REMS (range 0-26), and GAP (range 3-24) to predict in-hospital mortality among trauma patients. Higher EMTRAS and REMS scores, and lower GAP scores, are expected to correlate with increased mortality risk.

  From admission to hospital discharge or death, up to 30 days.

Secondary Outcomes (3)

• Accuracy Assessment of EMTRAS, REMS, and GAP Scores in Predicting the Need for Endotracheal Intubation

  From emergency department admission to intubation, discharge, or in-hospital death (up to 30 days).

• Accuracy Assessment of EMTRAS, REMS, and GAP Scores in Predicting Length of Hospitalization

  From hospital admission to discharge, up to 30 days.

• Accuracy Assessment of EMTRAS, REMS, and GAP Scores in Predicting In-Hospital Morbidity

  From hospital admission to discharge or death, up to 30 days.

Eligibility Criteria

• Age: 16 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population will consist of adult trauma patients (≥16 years) admitted to the emergency departments of participating tertiary hospitals in Iraq. Eligible patients will include those with blunt or penetrating trauma who present within 12 hours of injury. Patients will be assessed using EMTRAS, REMS, and GAP scores at admission, with outcomes monitored until discharge or in-hospital death.

You may qualify if:

• Patients presenting to the emergency department with trauma.
• Patients or their legal guardians must provide informed consent to participate in the study.
• Admission within 12 hours of injury.

You may not qualify if:

• Patients with incomplete clinical data or those discharged before scoring can be performed.
• Pregnant patients (due to specific physiological considerations not accounted for by the scoring system).
• Patients who died before arrival or were declared dead on arrival.
• Patients who refuse participation or for whom informed consent cannot be obtained.

Sponsors & Collaborators

• Al-Nahrain University: lead

Study Sites (1)

College of Medicine - Al-Nahrain University

Baghdad, 10001, Iraq

RECRUITING

Related Publications (17)

• Rehn M, Perel P, Blackhall K, Lossius HM. Prognostic models for the early care of trauma patients: a systematic review. Scand J Trauma Resusc Emerg Med. 2011 Mar 20;19:17. doi: 10.1186/1757-7241-19-17.

  PMID: 21418599 BACKGROUND

• WHO Global Health Estimates. INJURIES VIOLENCE THE FACTS.; 2014.https://iris.who.int/bitstream/handle/10665/149798/9789241508018_eng.pdf?sequence=1

  BACKGROUND

• Whitaker J, O'Donohoe N, Denning M, Poenaru D, Guadagno E, Leather AJM, Davies JI. Assessing trauma care systems in low-income and middle-income countries: a systematic review and evidence synthesis mapping the Three Delays framework to injury health system assessments. BMJ Glob Health. 2021 May;6(5):e004324. doi: 10.1136/bmjgh-2020-004324.

  PMID: 33975885 BACKGROUND

• Granstrom A, Schandl A, Martensson J, Strommer L. Using the GAP score as a complement to the NISS score in identifying severely injured patients- A registry-based cohort study of adult trauma patients in Sweden. Injury. 2024 Sep;55(9):111709. doi: 10.1016/j.injury.2024.111709. Epub 2024 Jun 28.

  PMID: 38969590 RESULT

• GJRA - Global Journal for Research Analysis - Diagnostic Accuracy of Rapid Emergency Medicine Score (REMS) as a prognostic marker and its comparison with traditional scoring systems in trauma. (n.d.). https://www.worldwidejournals.com/global-journal-for-research-analysis-GJRA/file.php?val=diagnostic-accuracy-of-rapid-emergency-medicine-score-rems-as-a-prognostic-marker-and-its-comparison-with-traditional-scoring-systems-in-trauma_January_2023_7615446958_8010945.pdf

  RESULT

• Karakus A, Yilmaz S, Demirci S, et al. An evaluation of trauma scores (RTS, GAP, EMTRAS) on mortality in multiple trauma patients. J Emerg Med. 2023;65(1):1-8. doi:10.1016/j.jemermed.2023.04.012

  RESULT

• Phunghassaporn N, Sukhvibul P, Techapongsatorn S, Tansawet A. Accuracy and external validation of the modified rapid emergency medicine score in road traffic injuries in a Bangkok level I trauma center. Heliyon. 2022 Dec 10;8(12):e12225. doi: 10.1016/j.heliyon.2022.e12225. eCollection 2022 Dec.

  PMID: 36568674 RESULT

• Joosse P, de Jong WJ, Reitsma JB, Wendt KW, Schep NW, Goslings JC. External validation of the Emergency Trauma Score for early prediction of mortality in trauma patients. Crit Care Med. 2014 Jan;42(1):83-9. doi: 10.1097/CCM.0b013e31829e53f5.

  PMID: 23982027 RESULT

• Mangini, M., Di Valvasone, S., Greco, C., Ognibene, A., Cappuccini, G., Spina, R., Tartaglia, R., Zagli, G., & Peris, A. (2010). Validation of the new proposed Emergency Trauma Score (EMTRAS). Critical Care, 14(Suppl 1), P252. https://doi.org/10.1186/cc8484

  RESULT

• Kumar, G., Kaur, R., Yadav, R., & Kachru, N. (2022). Comparison of Emergency Trauma Score (EMTRAS) with Rapid Emergency Medicine Score (REMS) for Prediction of Early Mortality in Adult Trauma Patients. Archives of Anesthesia and Critical Care. https://doi.org/10.18502/aacc.v8i3.9608

  RESULT

• Park HO, Kim JW, Kim SH, Moon SH, Byun JH, Kim KN, Yang JH, Lee CE, Jang IS, Kang DH, Kim SC, Kang C, Choi JY. Usability verification of the Emergency Trauma Score (EMTRAS) and Rapid Emergency Medicine Score (REMS) in patients with trauma: A retrospective cohort study. Medicine (Baltimore). 2017 Nov;96(44):e8449. doi: 10.1097/MD.0000000000008449.

  PMID: 29095289 RESULT

• Imhoff BF, Thompson NJ, Hastings MA, Nazir N, Moncure M, Cannon CM. Rapid Emergency Medicine Score (REMS) in the trauma population: a retrospective study. BMJ Open. 2014 May 2;4(5):e004738. doi: 10.1136/bmjopen-2013-004738.

  PMID: 24793256 RESULT

• Miller RT, Nazir N, McDonald T, Cannon CM. The modified rapid emergency medicine score: A novel trauma triage tool to predict in-hospital mortality. Injury. 2017 Sep;48(9):1870-1877. doi: 10.1016/j.injury.2017.04.048. Epub 2017 Apr 25.

  PMID: 28465003 RESULT

• Olsson T, Terent A, Lind L. Rapid Emergency Medicine score: a new prognostic tool for in-hospital mortality in nonsurgical emergency department patients. J Intern Med. 2004 May;255(5):579-87. doi: 10.1111/j.1365-2796.2004.01321.x.

  PMID: 15078500 RESULT

• Kumar G, Kaur R, Yadav R, Kachru N. Comparison of Emergency Trauma Score (EMTRAS) with Rapid Emergency Medicine Score (REMS) for prediction of early mortality in adult trauma patients. Arch Anesthesiol Crit Care. 2022;8(3):193-200.

  RESULT

• Ahun E, Koksal O, Sigirli D, Torun G, Donmez SS, Armagan E. Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department. Ulus Travma Acil Cerrahi Derg. 2014 Jul;20(4):241-7. doi: 10.5505/tjtes.2014.76399.

  PMID: 25135017 RESULT

• Mohammed S, Ali Y, Hasan M, et al. Trauma care in Iraq: challenges and opportunities. BMC Emerg Med. 2022;22:90. doi:10.1186/s12873-022-00653-1

  RESULT

MeSH Terms

Conditions

Wounds and Injuries

Central Study Contacts

Abdulillah R. Khamees, MBBCH

CONTACT

+9647838571013; abdulilah.r.khamis@gmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: September 16, 2025
• First Posted: September 22, 2025
• Study Start: September 15, 2025
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 15, 2026
• Last Updated: March 4, 2026

Record last verified: 2026-03

Locations

IR (1)