ArticleCureus2026
A Retrospective Study Examining the Effectiveness of the Study of the Management of Blunt Chest Wall Trauma (STUMBL) Scoring Tool in Predicting Complications Following Rib Fractures.
Article in Cureus, 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
Introduction Blunt thoracic trauma is a significant burden on the United Kingdom's National Health Service. A common scoring system utilised to predict complications and guide management is the STUMBL (Study of the Management of Blunt Chest Wall Trauma) tool. This study evaluates the utility of a STUMBL score of >11 in predicting complications. Methods A retrospective study of patients with rib fractures was conducted at the University Hospitals of North Midlands, a major trauma centre in England. The primary outcome was rib fracture-related complications, defined as the occurrence of ≥1 of the following: 90-day mortality, pulmonary complications (including infection, pleural effusion and empyema, haemothorax, pneumothorax, and pulmonary contusions), ICU admission, or a hospital stay of ≥7 days. The area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for a STUMBL score >11. Optimal cut-off scores for complications and 90-day mortality were also assessed. Results Between 01/06/2021 and 12/09/2023, 438 patients were enrolled in this study. A total of 199 patients were admitted to the hospital. Morbidity and mortality from rib fractures were 37.2% and 9.3%, respectively. The AUROC for a STUMBL score of >11 for all complications was 0.57 (sensitivity = 0.25, specificity = 0.88, PPV = 0.78, NPV = 0.41). The optimal STUMBL score for predicting overall complications and 90-day mortality was 18.5 (AUROC = 0.63) and 17.5 (AUROC = 0.62), respectively. Conclusion The STUMBL score of >11 poorly predicts complications in our population, whereas a score of 18.5 is more predictive. Further research is needed to determine if additional factors can enhance the utility of the STUMBL tool.
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