Medical Journal of the Islamic Republic Of Iran

other External Validation of the Trauma Early Mortality Prediction Tool (TEMPT) in an Iranian Trauma Population Emergency Medicine Emergency Medicine Original Research Original Research Background: Trauma remains the leading cause of mortality in the first four decades of life globally. Despite advances in trauma care, accurate early mortality prediction remains challenging. The Trauma Early Mortality Prediction Tool (TEMPT) was developed as a simplified scoring system, but its validity in diverse populations requires evaluation.    Methods: This cross-sectional study analyzed trauma patients admitted to Sina Hospital between 2019 and 2021. TEMPT variables, including age, systolic blood pressure, International Normalized Ratio (INR), Partial Thromboplastin Time (PTT), base excess, temperature, and traumatic brain injury (TBI) presence, were collected retrospectively. Glasgow Coma Scale (GCS) and Injury Severity Score (ISS) were also assessed. Logistic regression and ROC curve analysis compared TEMPT's predictive performance. Of 1,052 eligible patients, 809 (77%) were excluded due to incomplete data, potentially introducing selection bias. The primary outcome was in-hospital mortality.    Results: Of 1,052 eligible patients, complete data were available for 243 patients. The cohort was predominantly male (82.7%), with a mean age of 41.9±18.4 years. Overall mortality was 11.1%. Among TEMPT variables, only age (OR: 1.053, 95% CI: 1.02-1.08, P=0.002) and TBI presence (OR: 5.128, 95% CI: 1.28-20.47, P=0.021) significantly predicted mortality in multivariate analysis. GCS (OR: 0.754, 95% CI: 0.635-0.895, P=0.001) and ISS (OR: 1.042, 95% CI: 1.047-1.164, P<0.001) demonstrated superior predictive accuracy. ROC analysis showed an AUC of 0.586 (95% CI: 0.422–0.750) for TEMPT, 0.847 (95% CI: 0.745–0.949) for GCS, and 0.865 (95% CI: 0.786–0.944) for ISS.    Conclusion: TEMPT demonstrated limited external validity in this Iranian trauma population. Traditional scoring systems (GCS and ISS) outperformed TEMPT in mortality prediction. Population-specific validation and potential recalibration of scoring thresholds are essential before implementing TEMPT in diverse healthcare settings.   Trauma, Mortality Prediction, TEMPT, External Validation, Injury Severity Score, Glasgow Coma Scale 537 544 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-1129&slc_lang=other&sid=1 Mitra Oghazian mitra.oghazian@gmail.com 200319475328460098348 0009-0006-66842974 No Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran Atefeh Abdolahi aabdolahi@sina.tums.ac.ir 200319475328460098349 200319475328460098349 No Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Rasooli F.rasooli@sina.tums.ac.ir 200319475328460098350 200319475328460098350 No 2. Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Sepideh Aarabi saarabi@sina.tums.ac.ir 200319475328460098351 200319475328460098351 Yes Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran