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.
This protocol describes a prospective cohort designed to compare the prognostic performance of two prehospital/early trauma scores — MGAP (Mechanism, Glasgow Coma Scale, Age, Arterial Pressure) and GAP (Glasgow Coma Scale, Age, Systolic Blood Pressure) — for predicting key in-hospital outcomes among multiple trauma patients in Baghdad.
The investigators frame the work against a backdrop of high trauma burden in low- and middle-income and conflict-affected settings and note that these scores have not been validated in such environments in Iraq.
The investigation is a prospective, observational cohort to be conducted at Al-Kadhimiya Teaching Hospital in Baghdad.
Study enrolment is planned from April 2025 through March 2027.
Ethical approval was obtained from the College of Medicine, Al-Nahrain University Research Ethics Committee (UNCOMIRB20250383) for the period 7 March 2025 to 7 March 2027, and the trial is registered (NCT06732791).
Eligible participants are patients aged 16 years or older who present with multiple trauma within six hours of the injury event.
An estimated sample size of 522 participants is reported.
The protocol indicates that both written and verbal informed consent will be obtained prior to enrolment.
Collected data will include demographic variables, mechanism of injury, vital signs, and clinical outcomes resulting from the trauma.
Both MGAP and GAP scores will be calculated for enrolled patients based on recorded components (GCS, age, systolic/arterial blood pressure, and mechanism where applicable).
Primary prognostic targets are in-hospital mortality, intensive care unit admission, and requirement for surgical intervention.
Comparative performance of the two scores will be assessed using receiver operating characteristic (ROC) curve analysis with area under the curve (AUC) comparisons.
A statistical significance threshold is mentioned but the exact alpha value is not reported in the source.