Comparison of Chest Trauma Score, Revised Trauma Score, and Glasgow Coma Scale in Patients Visiting with Chest Trauma at the Emergency Department

Objective: Thoracic trauma is a significant cause of morbidity and mortality. Accurate assessment of trauma severity is essential for guiding treatment and predicting patient outcomes. This study aims to evaluate the comparative utility of the Glasgow coma scale (GCS), revised trauma score (RTS), and chest trauma score (CTS) to determine the most reliable tool for clinical decision-making in thoracic trauma cases.
Material and Methods: This prospective, observational cohort study was conducted at a level 1 trauma center between January and June 2015. A total of 110 patients presenting to the emergency department with thoracic trauma were included. Vital signs, trauma scores (GCS, RTS, and CTS), and clinical outcomes were recorded. Primary outcomes included the need for intubation, presence of pneumothorax, and discharge status. Statistical analyses included correlation tests and receiver operating characteristic curve analysis to assess the predictive power of trauma scores.
Results: The patients included in the study were 67.3% male and the mean age was 50.42 years. Patients requiring intubation had significantly lower GCS and RTS scores and higher CTS scores (p<0.001). CTS was significantly higher in patients with pneumothorax (p=0.007). A strong positive correlation was found between GCS and RTS (r=0.853, p<0.001), while CTS showed a low negative correlation with both scores (r=-0.283, p=0.003). CTS showed superior discriminatory power in predicting hospitalization (area under the curve:0.800).
Conclusion: GCS and head revised trauma score are more reliable for assessing overall trauma severity, whereas CTS is more effective in evaluating the severity of chest trauma. A combined approach utilizing all three scores may enhance risk stratification and improve clinical outcomes in patients with thoracic trauma.

Keywords: Chest trauma score, revised trauma score, Glasgow coma scale, thoracic trauma