Predictive Value of Chest Trauma Score , Revised Trauma Score , and Glasgow Coma Scale in Patients Presenting With Chest Trauma at Assiut University Emergency Unit.

Inclusion criteria

• Age threshold: Patients aged 18 years and older (pediatric physiology requires entirely different trauma scoring systems).
• Mechanism of injury: Patients presenting with acute blunt or penetrating thoracic trauma or both.
• Diagnostic confirmation: Patients with documented clinical or radiological evidence of chest injury (e.g., rib fractures, pulmonary contusion, pneumothorax, or hemothorax confirmed via X-ray, chest CT, or FAST).
• Time of presentation: Patients presenting directly to the emergency department within 24 hours of the trauma incident.

Exclusion criteria

• Inter-facility transfers: Exclude patients transferred from other hospitals. If they were already intubated, given sedatives, or resuscitated elsewhere, their admission scores will be artificially altered and will not reflect their true initial presentation.
• Dead on Arrival (DOA): Patients who arrive in cardiac arrest or expire before the initial primary survey and scoring can be completed.
• Isolated severe head trauma or massive burns: Patients whose clinical picture and need for intubation are overwhelmingly driven by severe traumatic brain injury (e.g., GCS < 8 from head injury alone without significant chest trauma) or massive burns, rather than the thoracic injury.
• Severe chronic cardiopulmonary disease: patients with known end-stage COPD, severe baseline heart failure, or those on home oxygen. Their baseline hypoxia or need for ventilation can confound the trauma scores' predictive value.
• Incomplete data: Patients whose medical records are missing the crucial variables needed to calculate the GCS, RTS, or CTS upon arrival.