Road traffic injuries remain a leading cause of preventable death and disability globally. To improve risk stratification and resource allocation, various prognostic scoring tools have been introduced over the years. This study was conducted to assess the ability of the modified Rapid Emergency Medicine Score (mREMS) to predict in-hospital mortality in victims of road traffic crashes and to determine how its performance compares to that of two established trauma scores: the Revised Trauma Score (RTS) and the MGAP (Mechanism, Glasgow Coma Scale, Age, and Arterial Pressure) score. We retrospectively reviewed 1,033 road traffic injury cases from the trauma registry at Vajira Hospital. The modified Rapid Emergency Medicine Score (mREMS) was derived using six physiological and clinical parameters: age, systolic blood pressure, heart rate, respiratory rate, peripheral oxygen saturation, and Glasgow Coma Scale score. Discriminatory performance was evaluated by constructing receiver operating characteristic (ROC) curves and calculating the area under the curve (AUC) with 95% confidence intervals. The AUC of mREMS was directly compared with those of the Revised Trauma Score (RTS) and the MGAP score. Calibration of each model was examined using the Hosmer–Lemeshow goodness-of-fit test. The modified Rapid Emergency Medicine Score (mREMS) outperformed the Revised Trauma Score (RTS) in predicting in-hospital mortality among road traffic injury patients, with an AUC of 0.909 (95% CI 0.866–0.951) versus 0.859 (95% CI 0.791–0.927) for RTS (p = 0.023). When compared to the MGAP score, however, mREMS showed comparable discriminatory power, with no significant difference between their AUCs (p = 0.150). Additionally, mREMS displayed adequate calibration in this population, as indicated by a non-significant Hosmer–Lemeshow test (p = 0.277). In patients with road traffic injuries, the modified Rapid Emergency Medicine Score (mREMS) proved to be a highly effective tool for predicting in-hospital mortality. These findings support its potential use in enhancing triage accuracy at the point of care. Nevertheless, additional external validation across multiple trauma centers is recommended prior to broader or nationwide adoption.
