---
title: "Validation of the STUMBL Score vs ISS for Predicting Outcomes in Blunt Thoracic Trauma"
id: "pubmed-42003070"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42003070"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42003070/"
doi: "10.5090/jcs.25.143"
published_at: "2026-09-05T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Validation of the STUMBL Score vs ISS for Predicting Outcomes in Blunt Thoracic Trauma
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42003070
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42003070/)
- **DOI:** [10.5090/jcs.25.143](https://doi.org/10.5090%2Fjcs.25.143)
- **Published At:** 2026-09-05T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This prospective cohort study at Dr. Saiful Anwar General Hospital in Malang, Indonesia evaluated the performance of the **STUMBL score** versus the **Injury Severity Score (ISS)** for patients with blunt thoracic trauma. - Study period was February 2024 to April 2025 and included adult patients (≥18 years) with confirmed blunt thoracic trauma and a Glasgow Coma Scale of 14–15. - Demographic, clinical, and radiologic data were recorded at admission; both ISS and STUMBL scores were calculated on arrival. - Primary outcomes were prolonged hospitalization (≥7 days), intensive care unit (ICU) admission, and in-hospital mortality. - The cohort comprised 371 patients; 75.7% were male, median age was 43 years, and 69.5% of injuries resulted from road traffic accidents. - ICU admission occurred in 18.3% of patients and in-hospital mortality was 5.4%. - Both ISS and STUMBL were significantly higher in patients who experienced adverse outcomes (p 10.5 produced sensitivities of approximately 70.0–74.1% and specificities of 80.6–92.4% for the reported outcomes. - ISS showed lower discriminative performance with AUC values between 0.753 and 0.802. - The authors conclude that applying the **STUMBL score** may improve early risk stratification and clinical decision-making for blunt thoracic trauma in Indonesian tertiary hospitals.
## Clinical Analysis & Structured Key Points
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Epub 2026 Apr 20. # Improving Blunt Thoracic Trauma Prognosis: Validation of the Study of the Management of Blunt Chest Wall Trauma Score against Injury Severity Score in an Indonesian Tertiary Hospital [Artono Isharanto](https://pubmed.ncbi.nlm.nih.gov/?term=Isharanto+A&cauthor_id=42003070)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42003070/#full-view-affiliation-1 "Department of Thoracic, Cardiac and Vascular Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia."), [Eric Yayang Suhanda](https://pubmed.ncbi.nlm.nih.gov/?term=Suhanda+EY&cauthor_id=42003070)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42003070/#full-view-affiliation-2 "Department of General Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia."), [Imam Suseno Bayuadi](https://pubmed.ncbi.nlm.nih.gov/?term=Bayuadi+IS&cauthor_id=42003070)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42003070/#full-view-affiliation-1 "Department of Thoracic, Cardiac and Vascular Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia."), [Koernia Kusuma Wardhana](https://pubmed.ncbi.nlm.nih.gov/?term=Wardhana+KK&cauthor_id=42003070)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42003070/#full-view-affiliation-1 "Department of Thoracic, Cardiac and Vascular Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia."), [Gracelia Ruth Elisabeth Damanik](https://pubmed.ncbi.nlm.nih.gov/?term=Damanik+GRE&cauthor_id=42003070)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42003070/#full-view-affiliation-1 "Department of Thoracic, Cardiac and Vascular Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia."), [Chaidar Muttaqin](https://pubmed.ncbi.nlm.nih.gov/?term=Muttaqin+C&cauthor_id=42003070)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42003070/#full-view-affiliation-1 "Department of Thoracic, Cardiac and Vascular Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.") Affiliations Expand ### Affiliations * 1 Department of Thoracic, Cardiac and Vascular Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia. * 2 Department of General Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia. * PMID: **42003070** * DOI: [ 10.5090/jcs.25.143 ](https://doi.org/10.5090/jcs.25.143) Free article Item in Clipboard # Improving Blunt Thoracic Trauma Prognosis: Validation of the Study of the Management of Blunt Chest Wall Trauma Score against Injury Severity Score in an Indonesian Tertiary Hospital Artono Isharanto et al. J Chest Surg. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID J Chest Surg Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Chest+Surg%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Chest+Surg%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42003070/) . 2026 Sep 5;59(5):202-210. doi: 10.5090/jcs.25.143. Epub 2026 Apr 20. ### Authors [Artono Isharanto](https://pubmed.ncbi.nlm.nih.gov/?term=Isharanto+A&cauthor_id=42003070)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42003070/#short-view-affiliation-1 "Department of Thoracic, Cardiac and Vascular Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia."), [Eric Yayang Suhanda](https://pubmed.ncbi.nlm.nih.gov/?term=Suhanda+EY&cauthor_id=42003070)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42003070/#short-view-affiliation-2 "Department of General Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia."), [Imam Suseno Bayuadi](https://pubmed.ncbi.nlm.nih.gov/?term=Bayuadi+IS&cauthor_id=42003070)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42003070/#short-view-affiliation-1 "Department of Thoracic, Cardiac and Vascular Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia."), [Koernia Kusuma Wardhana](https://pubmed.ncbi.nlm.nih.gov/?term=Wardhana+KK&cauthor_id=42003070)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42003070/#short-view-affiliation-1 "Department of Thoracic, Cardiac and Vascular Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia."), [Gracelia Ruth Elisabeth Damanik](https://pubmed.ncbi.nlm.nih.gov/?term=Damanik+GRE&cauthor_id=42003070)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42003070/#short-view-affiliation-1 "Department of Thoracic, Cardiac and Vascular Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia."), [Chaidar Muttaqin](https://pubmed.ncbi.nlm.nih.gov/?term=Muttaqin+C&cauthor_id=42003070)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42003070/#short-view-affiliation-1 "Department of Thoracic, Cardiac and Vascular Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.") ### Affiliations * 1 Department of Thoracic, Cardiac and Vascular Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia. * 2 Department of General Surgery, Dr. Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia. * PMID: **42003070** * DOI: [ 10.5090/jcs.25.143 ](https://doi.org/10.5090/jcs.25.143) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Blunt thoracic trauma is a leading cause of trauma-related morbidity and mortality worldwide. Although the Injury Severity Score (ISS) is widely used to assess overall trauma severity, it lacks specificity for thoracic injuries. The Study of the Management of Blunt Chest Wall Trauma (STUMBL) score, which incorporates age, number of rib fractures, chronic lung disease, oxygen saturation, and pre-injury anticoagulant use, has not been validated in the Indonesian clinical setting. **Methods:** A prospective cohort study was conducted at Dr. Saiful Anwar General Hospital, Malang, Indonesia, between February 2024 and April 2025. Adult patients (≥18 years) with confirmed blunt thoracic trauma and a Glasgow Coma Scale score of 14-15 were included. Demographic, clinical, and radiologic variables were recorded, and ISS and STUMBL scores were calculated at admission. Outcomes included prolonged hospitalization (≥7 days), intensive care unit (ICU) admission, and in-hospital mortality. Statistical analyses included the Mann-Whitney U test and receiver operating characteristic curve analysis. **Results:** Among 371 patients, 75.7% were male, with a median age of 43 years. Road traffic accidents accounted for 69.5% of cases. ICU admission occurred in 18.3% of patients, and in-hospital mortality was 5.4%. Both ISS and STUMBL scores were significantly higher among patients with adverse outcomes (p 10.5 yielded sensitivities ranging from 70.0% to 74.1% and specificities ranging from 80.6% to 92.4%. In contrast, ISS demonstrated lower AUC values (0.753-0.802) and reduced discriminatory ability. **Conclusion:** The STUMBL score outperformed ISS in predicting prolonged hospitalization, ICU admission, and in-hospital mortality among patients with blunt thoracic trauma. Its application may improve early risk stratification and support clinical decision-making in Indonesian tertiary hospitals. **Keywords:** Injury Severity Score; Nonpenetrating wounds; Prognosis; STUMBL score; Thoracic injuries; Trauma severity indices. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Appraisal of early evaluation of blunt chest trauma: development of a standardized scoring system for initial clinical decision making. ](https://pubmed.ncbi.nlm.nih.gov/11003329/) Pape HC, Remmers D, Rice J, Ebisch M, Krettek C, Tscherne H.Pape HC, et al.J Trauma. 2000 Sep;49(3):496-504. doi: 10.1097/00005373-200009000-00018.J Trauma. 2000.PMID: 11003329 * [ External retrospective validation of the STUMBL score for patients with isolated blunt thoracic trauma presenting to the emergency department. ](https://pubmed.ncbi.nlm.nih.gov/40976766/) Blais S, Boucher V, Brière R, Tardif A, Malo C, Mercier É, Blanchard PG, Benhamed A, Fouzail M, Émond M.Blais S, et al.Injury. 2026 Jan;57(1):112761. doi: 10.1016/j.injury.2025.112761. Epub 2025 Sep 15.Injury. 2026.PMID: 40976766 * [ A retrospective validation study of the STUMBL score for emergency department patients with blunt thoracic trauma. ](https://pubmed.ncbi.nlm.nih.gov/36028375/) Giamello JD, Martini G, Prato D, Santoro M, Arese Y, Melchio R, Bertolaccini L, Battle CE, Driscoll T, Sciolla A, Lauria G.Giamello JD, et al.Injury. 2023 Jan;54(1):39-43. doi: 10.1016/j.injury.2022.08.028. Epub 2022 Aug 14.Injury. 2023.PMID: 36028375 * [ Scoping review of the literature to ascertain how the STUMBL Score clinical prediction model is used to manage patients with blunt chest wall trauma in emergency care. ](https://pubmed.ncbi.nlm.nih.gov/37208252/) Battle C, Cole E, Whelan R, Baker E.Battle C, et al.Injury. 2023 Jul;54(7):110796. doi: 10.1016/j.injury.2023.05.027. Epub 2023 May 7.Injury. 2023.PMID: 37208252 * [ Lessons from a large trauma center: impact of blunt chest trauma in polytrauma patients-still a relevant problem? ](https://pubmed.ncbi.nlm.nih.gov/28427480/) Chrysou K, Halat G, Hoksch B, Schmid RA, Kocher GJ.Chrysou K, et al.Scand J Trauma Resusc Emerg Med. 2017 Apr 20;25(1):42. doi: 10.1186/s13049-017-0384-y.Scand J Trauma Resusc Emerg Med. 2017.PMID: 28427480Free PMC article.Review. 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