Comparison of Trauma Scoring Systems for Predicting Mortality in Emergency Department Patients with Multiple Trauma Caused by Traffic Accidents: A Prospective Cross-Sectional Study

Background This study evaluates the effectiveness of trauma scoring systems in predicting mortality among patients admitted to the emergency department following traffic accidents. Methods A prospective cross-sectional study was conducted on multiple trauma patients at a tertiary university hospital from April 2022 to April 2023. Trauma scores, including ISS, NISS, AIS, GCS, RTS, and APACHE II, were calculated and analysed for their association with mortality. Demographic characteristics and comorbidities were also assessed. Results A total of 554 patients (median age: 36 years; 67.5% male) were included. Extremity injuries (61.7%) were the most common, followed by head and neck injuries (44%). Deceased patients exhibited significantly higher scores in APACHE II (median: 20 vs. 5, p < 0.001), ISS (median: 12 vs. 2, p < 0.001), NISS (median: 12 vs. 2, p < 0.001), and AIS (median: 2 vs. 1, p < 0.001), while RTS (median: 4.09 vs. 7.84, p < 0.001) and GCS (median: 4 vs. 15, p < 0.001) were lower. Hospitalized patients also had higher APACHE II, ISS, NISS, and AIS scores and lower GCS scores (p < 0.001 for all comparisons). Strong correlations were observed between ISS and NISS (Spearman’s Rho = 0.97, p < 0.001). Elevated WBC and reduced haematocrit and bicarbonate levels were significantly associated with mortality (p < 0.05). Conclusion RTS and APACHE II are practical tools for emergency departments, offering rapid physiological assessment and comprehensive evaluation, respectively. ISS and NISS remain reliable for predicting injury severity and mortality risk. Incorporating these scoring systems into trauma care protocols can enhance early risk stratification and inform clinical decision-making in emergency settings.