Trauma is a significant cause of mortality and morbidity around the world. Approximately
10% of the burden of disease in adults is due to traumatic injuries. Trauma can lead to
serious consequences, including disabilities, psychosocial burdens, and increased
mortality among the actively working population. Cardiopulmonary arrest, unplanned
admissions to intensive care units, and nosocomial infections are some complications
faced by trauma patients admitted to trauma centers. The estimated mortality rate for
hospitalized trauma patients is 11%. The in-hospital mortality rate for trauma patients
who undergo cardiopulmonary resuscitation (CPR) is 92.7%. Trauma-related mortality and
morbidity depend on injury severity, diagnostic delays, and the time taken to reach a
medical facility.Timely evaluation, effective post-trauma care, and appropriate triage
can significantly reduce long-term mortality and morbidity among trauma patients, with
rapid assessment of trauma severity being crucial for the primary triage of multiple
trauma patients.
Trauma scoring systems are valuable tools for quickly assessing the severity of injuries
and predicting patient outcomes. By utilizing these scoring systems, healthcare providers
can enhance the organization of trauma patient triage, optimize resource allocation, and
conduct immediate evaluations of potential complications. Several scoring systems have
been developed to assess trauma cases. These trauma scores are classified into three
categories: anatomical (such as the Abbreviated Injury Scale and Injury Severity Score),
physiological (like the Revised Trauma Score), and combined (such as the Trauma and
Injury Severity Score). Physiological scores can be determined during the initial
clinical assessment of the patient, while anatomical scoring can be performed later after
the patient has been stabilized. This makes it easier to stratify trauma patients
effectively. On the other hand, combined scores that include both anatomical and
physiological criteria are more useful for patient prognosis. One such combined score is
the Trauma and Injury Severity Score (TRISS), which was designed by the Major Trauma
Outcome Study (MTOS) in the United States to predict the outcome in polytrauma patients
and includes the Injury Severity Score (ISS) and Revised Trauma Score (RTS).
Trauma is thus now a significant health challenge in Iraq. Through the long fight in
Iraq, more and more people are experiencing violence-related injuries, such as from
firearms and attacks. The work also demonstrates that violence is one of the primary
determinants of public health because it leads to complications with injuries and the
psychological development of the survivors in the course of their lives. The Iraqi
healthcare system has documented a significant rise in RTAs (road traffic accidents),
particularly since the escalation of conflict around 2013. Trauma care system is not well
established, and few protocols are followed clinically, and no scientific method is well
established to predict the outcome in trauma patients in Iraq. This is made worse by
scarce resources, inadequate staffing and educational preparedness of medical personnel,
and the overall lack of formalized trauma registry databases that could well monitor
patient results. In the Iraqi context, only a few studies have demonstrated the use of
different trauma scores to predict outcomes in patients with trauma.
There is a significant research gap regarding the use of trauma scoring systems,
especially TRISS, in Iraq. Most studies focus on descriptive outcomes rather than
evaluating global trauma scores in the unique Iraqi context. Resource limitations,
inconsistent pre-hospital care, and conflict-related injuries complicate the application
of these systems. The lack of standardized trauma registries and data collection further
limits the ability to improve trauma care and emergency services in Iraq.