Objectives: This study aimed to assess the predictive value of the Modified Early Warning Score (MEWS) and Revised Trauma Score (RTS) for emergency trauma patients who died within 24 hours.

Design: A retrospective, single-centered study.

Setting: This study was conducted at a tertiary hospital in Southern China.

Participants: A total of 1739 patients with acute trauma, aged 16 years or older who presented to the emergency department from November 1, 2016, to November 30, 2019, were included.

Interventions: None.

Outcome: 24-hour mortality was the primary outcome of trauma.

Results: 1739 patients were divided into the survival group (1709 patients,98.27%), and the non-survival group (30 patients,1.73%). Crude OR and adjusted OR of MEWS were 1.99, 95%CI (1.73-2.29), and 2.00, 95%CI (1.74-2.31), P<0.001, respectively. Crude OR and adjusted OR of RTS were 0.62, 95%CI (0.55-0.69), and 0.61, 95%CI (0.55-0.68), P<0.001, respectively. The area under the curve (AUC) of MEWS was significantly higher than that of RTS (P=0.005): 0.927, 95%CI (0.914-0.939) vs 0.799, 95%CI (0.779-0.817).

Conclusions: Both MEWS and RTS were independent predictors of the short-term prognosis in emergency trauma patients, MEWS had better predictive efficacy.