Validation of the study of the management of blunt chest wall trauma (STUMBL) score - predicting in-hospital complications

Q: What is the purpose of validating the STUMBL score?

To assess whether the STUMBL score can predict in-hospital complications in patients with blunt chest trauma admitted to an emergency department.

Q: How was the study conducted and what outcomes were evaluated?

A retrospective cohort study was performed from January 2022 to January 2024, using electronic health records, and complications included pulmonary infections, pleural effusion, pneumothorax, ICU admission, and prolonged hospital stay.

Q: What discriminative performance and cutoff value did the STUMBL score achieve?

The STUMBL score showed strong discrimination with AUROC 0.934 and AUPRC 0.889, with an optimal cutoff of 20.5 rounded to ≥21, yielding sensitivity 84% and specificity 89%.

Sep 30, 2026

Uploaded by CatatanPagi

BACKGROUND: This study validates the Study of the Management of Blunt Chest Wall Trauma (STUMBL) score as a prognostic tool for in-hospital complications in adults with blunt chest trauma admitted to a tertiary emergency department. METHODS: A retrospective cohort was conducted from January 2022 to January 2024 using electronic health records; outcomes included pulmonary infections, pleural effusion, pneumothorax, ICU admission, and prolonged stay. ROC and precision-recall analyses assessed discriminative performance (AUROC, AUPRC). RESULTS: 536 patients were analyzed; 28.0% developed complications. Higher STUMBL scores correlated with events, with AUROC 0.934 and AUPRC 0.889. An optimal cutoff of 20.5 (rounded to ≥21) achieved sensitivity 84% and specificity 89%. CONCLUSION: The STUMBL score shows excellent predictive performance and is suitable for emergency clinical decision-making.

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CategoryHealthcare

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ORIGINAL ARTICLE Validation of the study of the management of blunt chest wall trauma (STUMBL) score for predicting in-hospital complications in patients with blunt chest trauma Erdal Yılmaz,1 Rohat Ak,1 Avni Uygar Seyhan,1 Recep Demirhan2 1Department of Emergency Medicine, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul-Türkiye 2Department of Thoracic Surgery, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul-Türkiye ABSTRACT BACKGROUND: This study aimed to validate the Study of the Management of Blunt Chest Wall Trauma (STUMBL) score as a prognostic tool for predicting in-hospital complications in patients with blunt chest trauma admitted to a tertiary care hospital emergency department. METHODS: A retrospective cohort study was conducted between January 2022 and January 2024. Adult patients (≥18 years) diagnosed with blunt thoracic trauma were included. Data were collected from electronic health records. Complications included pulmonary infections, pleural effusion, pneumothorax, intensive care unit (ICU) admission, and prolonged hospital stay. Discriminative performance was evaluated using receiver operating characteristic (ROC) analysis, with calculation of the area under the ROC curve (AUROC) and the area under the precision-recall curve (AUPRC). RESULTS: A total of 536 patients were included, of whom 150 (28.0%) developed in-hospital complications. Patients with complications had significantly higher STUMBL scores (median 13 vs. 6, p<0.001). The STUMBL score demonstrated strong discriminative ability, with an AUROC of 0.934 (95% confidence interval [CI], 0.909-0.959) and an AUPRC of 0.889 (95% CI: 0.847-0.924). The optimal cutoff value identified was 20.5; for clinical applicability, this was rounded to ≥21, yielding a sensitivity of 84% and a specificity of 89%. CONCLUSION: The STUMBL score demonstrated excellent performance in predicting in-hospital complications among patients with blunt chest trauma. Its simplicity and strong predictive value suggest it can be effectively incorporated into emergency department clinical decision-making. Keywords: The Study of the Management of Blunt Chest Wall Trauma (STUMBL) score; blunt chest trauma; risk stratification. INTRODUCTION Blunt chest trauma is a common cause of emergency department admissions worldwide, with clinical presentations ranging from minor contusions to life-threatening thoracic injuries. In the United States, it accounts for approximately 15% of trauma-related hospital visits, with significant implications for morbidity and healthcare resource utilization. Recent research has emphasized the importance of simple, accessible clinical predictors in thoracic trauma to support early decision-making and risk stratification.[1,2] Early identification of patients at increased risk of complications is essential for guiding management decisions, allocating resources efficiently, and improving clinical outcomes.[3,4] Several clinical prediction tools have been developed to aid risk stratification in trauma patients, but few have demonstrated consistent external validity across different populations. | Cite this article as: Yılmaz E, Ak R, SeyhanAU, Demirhan R. Validation of the study of the management of blunt chest wall trauma (STUMBL) score for predicting in-hospital complications inpatients with blunt chest trauma. Ulus Travma Acil Cerrahi Derg 2025;31:959-965.
Address for correspondence: Erdal Yılmaz
Department of Emergency Medicine, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Türkiye
E-mail: erdalyi[lmazmd@gmail.com](lmazmd@gmail.com) | | | --- | --- | | Ulus Travma Acil Cerrahi Derg 2025;31(10):959-965 DOI: 10.14744/tjtes.2025.72690
Submitted: 30.04.2025 Revised: 09.09.2025 Accepted: 12.09.2025 Published: 07.10.2025
OPEN ACCESS This is an open access article under the CC BY-NC license ([http://creativecommons.org/licenses/by-nc/4.0/](http://creativecommons.org/licenses/by-nc/4.0/)). | | Ulus Travma Acil Cerrahi De

FAQs

What is the purpose of validating the STUMBL score?

To assess whether the STUMBL score can predict in-hospital complications in patients with blunt chest trauma admitted to an emergency department.

How was the study conducted and what outcomes were evaluated?

A retrospective cohort study was performed from January 2022 to January 2024, using electronic health records, and complications included pulmonary infections, pleural effusion, pneumothorax, ICU admission, and prolonged hospital stay.

What discriminative performance and cutoff value did the STUMBL score achieve?

The STUMBL score showed strong discrimination with AUROC 0.934 and AUPRC 0.889, with an optimal cutoff of 20.5 rounded to ≥21, yielding sensitivity 84% and specificity 89%.

Sep 30, 2026

Uploaded by CatatanPagi