Aims and Objectives Introduction: Chest injuries account for a high proportion of hospital admissions and delayed mortality in trauma patients. The Battle Score was derived in a UK Major Trauma Centre, externally validated in 7 UK hospitals and has been widely adopted as a risk stratification and prognostication tool for chest trauma. However validation studies among the older, frailer cohort of trauma patients who tend to be managed in Trauma Units are limited.

Aims: To describe the demographics of patients admitted with chest injuries at a regional Trauma Unit in Southeast Scotland and compare complication and mortality rates with the original Battle cohort.

Method and Design Retrospective analysis of discharge summaries of 131 patients admitted with chest trauma at the Victoria Hospital, NHS Fife between 2022 and 2023.

Results and Conclusion Results: Median [IQR] age in the NHS Fife cohort was 76 [25] compared with 69 [28] and 57 [34] in the original derivation and validation cohorts respectively. Table 1 compares complication rates by Battle Score in the NHS Fife cohort and the original cohort. The most common complication across all Battle Scores was hospital stay ≥7 days which accounted for 48.1% of total complications.

Discussion In patients with chest trauma presenting to our regional Trauma Unit the complication rate at lower Battle Scores is substantially higher than that originally reported by Battle, while the complication rate at higher Battle Scores is very similar. The population in our study is substantially older than both the derivation and validation cohorts. Complication rates in our cohort are largely driven by hospital length of stay, which may relate more to pre-existing frailty and increased care requirements after trauma. Battle Score should therefore be used with caution as a prognostic tool in our patient population, particularly at lower scores which may significantly underestimate the likelihood of prolonged hospital admission.