ArticleJournal of trauma and injury2026
Use of the Obstetric Early Warning Score in emergency triage for pregnant trauma patients: a retrospective cross-sectional study on a tool for early hospitalization decision-making.
Article in Journal of trauma and injury, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTraumatic injuries during pregnancy present significant challenges for emergency providers, necessitating rapid assessment to ensure the safety of both mother and fetus. Scoring systems that can be applied immediately upon presentation may facilitate early triage and inform disposition decisions. This study evaluated the predictive performance of the Obstetric Early Warning Score (OEWS), Injury Severity Score (ISS), and Revised Trauma Score (RTS) in determining hospitalization needs among pregnant trauma patients admitted to the emergency department (ED).
methodsThis retrospective cross-sectional study included pregnant trauma patients aged 18 years or older who were admitted to a tertiary care ED between January 2019 and December 2022. Demographic, clinical, laboratory, and trauma-related data were collected. OEWS, ISS, and RTS were calculated at admission. The primary outcome was the requirement for hospitalization. Binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess predictive performance.
resultsA total of 316 pregnant trauma patients were included. Hospitalization was required in 14.9% of cases. Higher OEWS (mean, 2.63 vs. 0.33; P=0.001) and ISS (mean, 18.02 vs. 5.04; P<0.001) were significantly associated with hospitalization. In multivariate analysis, OEWS (odds ratio [OR], 1.553; 95% confidence interval [CI], 1.087-2.219; P=0.016) and ISS (OR, 1.170; 95% CI, 1.083-1.264; P<0.001) were independent predictors of hospitalization. ROC analysis demonstrated that ISS had the highest predictive value (area under the curve, 0.783; 95% CI, 0.695-0.870; P<0.001).
conclusionsBoth ISS and OEWS are effective tools for predicting hospitalization needs in pregnant trauma patients. Incorporating these scoring systems into ED triage protocols may enhance early identification of high-risk patients and improve outcomes for both mothers and fetuses.
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