Journals / Journal of Health Sciences and Medicine / 2026 / Volume: 9 Issue: 6

Comparative prognostic performance of clinical scores and serum lactate in ICU patients with thoracic trauma

Pages
—
Publication Date
2026-10-25
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

SOFA yielded the highest observed AUC for mortality in the overall cohort (AUC: 0.938), although its AUC did not differ significantly from that of TTSS after Holm adjustment (adjusted p=0.843); TTSS yielded the highest observed AUC in patients with isolated thoracic trauma (AUC: 0.998).

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aims: Accurate prognostic assessment in thoracic trauma patients admitted to the intensive care unit (ICU) remains a critical yet unresolved issue.
📊
Key Findings & Data:This study aimed to compare the predictive performance of commonly used clinical scoring systems and serum lactate levels in this population.
💡
Conclusion & Impact:SOFA yielded the highest observed AUC for mortality in the overall cohort (AUC: 0.938), although its AUC did not differ significantly from that of TTSS after Holm adjustment (adjusted p=0.843); TTSS yielded the highest observed AUC in patients with isolated thoracic trauma (AUC: 0.998).
🔬Design:Modeling & Simulation
📍Scope:2021 Verileri
⚙️Variables:Thoracic injuries · intensive care units · Severity of Illness Index

Abstract

Aims: Accurate prognostic assessment in thoracic trauma patients admitted to the intensive care unit (ICU) remains a critical yet unresolved issue. This study aimed to compare the predictive performance of commonly used clinical scoring systems and serum lactate levels in this population. Methods: A retrospective cohort of 178 adult ICU patients with thoracic trauma treated between 2021 and 2025 was analyzed. Thoracic Trauma Severity Score (TTSS), APACHE II, SOFA, and admission lactate levels were evaluated. Mortality within 28 days was defined as the primary endpoint, while in-hospital complications were assessed as secondary outcomes. Discriminative performance was examined using receiver operating characteristic analysis. Adjusted associations with 28-day mortality were evaluated using separate multivariable logistic regression models. Results: Mortality occurred in 23.0% of patients, and complications were observed in 36.0%. All evaluated parameters were significantly elevated in non-survivors and in patients who developed complications. SOFA yielded the highest observed AUC for mortality in the overall cohort (AUC: 0.938), although its AUC did not differ significantly from that of TTSS after Holm adjustment (adjusted p=0.843); TTSS yielded the highest observed AUC in patients with isolated thoracic trauma (AUC: 0.998). In separate models adjusted for age, gender, trauma mechanism, and concomitant injury, all four parameters remained associated with 28-day mortality (all p<0.001). In contrast, lactate demonstrated comparatively lower predictive ability. Conclusion: SOFA and TTSS demonstrated strong discrimination in the overall cohort, with no statistically significant difference between their AUCs. TTSS yielded the highest observed AUC in the isolated thoracic trauma subgroup. These findings support the use of both organ dysfunction-based and trauma-specific scoring systems in prognostic assessment.

🔖

Cite This Article

Ancın, B., Gülsoy, K. Y. (2026). Comparative prognostic performance of clinical scores and serum lactate in ICU patients with thoracic trauma. Journal of Health Sciences and Medicine, Volume: 9 Issue: 6. https://ajindex.com/articles/1668040

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (24)

  1. Battle CE, Hutchings H, Evans PA. Risk factors that predict mortality in patients with blunt chest wall trauma: a systematic review and meta-analysis. Injury. 2012;43(1):8-17. doi:10.1016/j.injury.2011.01.004
  2. Veysi VT, Nikolaou VS, Paliobeis C, Efstathopoulos N, Giannoudis PV. Prevalence of chest trauma, associated injuries and mortality: a level I trauma centre experience. Int Orthop. 2009;33(5):1425-1433. doi:10.1007/s00264-009-0746-9
  3. Mommsen P, Zeckey C, Andruszkow H, et al. Comparison of different thoracic trauma scoring systems in regards to prediction of post-traumatic complications and outcome in blunt chest trauma. J Surg Res. 2012;176(1):239-247. doi:10.1016/j.jss.2011.09.018
  4. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13(10):818-829.
  5. Vincent JL, Moreno R, Takala J, et al. The SOFA (Sepsis-Related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996;22(7):707-710. doi:10.1007/BF01709751
  6. Kanake V, Kale K, Mangam S, Bhalavi V. Thorax Trauma Severity Score in patients with chest trauma: study at a tertiary-level hospital. Indian J Thorac Cardiovasc Surg. 2022;38(2):149-156. doi:10.1007/s12055-021-01312-z
  7. Moon SH, Kim JW, Byun JH, et al. The Thorax Trauma Severity Score and the Trauma and Injury Severity Score: do they predict in-hospital mortality in patients with severe thoracic trauma? A retrospective cohort study. Medicine (Baltimore). 2017;96(42):e8317. doi:10.1097/MD.0000000000008317
  8. Odom SR, Howell MD, Silva GS, et al. Lactate clearance as a predictor of mortality in trauma patients. J Trauma Acute Care Surg. 2013;74(4):999-1004. doi:10.1097/TA.0b013e3182858a3e
  9. Lundin A, Akram SK, Berg L, Göransson KE, Enocson A. Thoracic injuries in trauma patients: epidemiology and its influence on mortality. Scand J Trauma Resusc Emerg Med. 2022;30(1):69. doi:10.1186/s13049-022-01058-6
  10. Yazıcı R, Bulut B, Genc M, et al. Prognostic indicators in patients with isolated thoracic trauma: a retrospective cross-sectional study. Ulus Travma Acil Cerrahi Derg. 2024;30(10):737-744. doi:10.14744/tjtes.2024.15003
  11. Pape HC, Remmers D, Rice J, Ebisch M, Krettek C, Tscherne H. Appraisal of early evaluation of blunt chest trauma: development of a standardized scoring system for initial clinical decision making. J Trauma. 2000;49(3):496-504. doi:10.1097/00005373-200009000-00018
  12. Ulvik A, Kvåle R, Wentzel-Larsen T, Flaatten H. Multiple organ failure after trauma affects even long-term survival and functional status. Crit Care. 2007;11(5):R95. doi:10.1186/cc6111
  13. Dübendorfer C, Billeter AT, Seifert B, Keel M, Turina M. Serial lactate and admission SOFA scores in trauma: an analysis of predictive value in 724 patients with and without traumatic brain injury. Eur J Trauma Emerg Surg. 2013;39(1):25-34. doi:10.1007/s00068-012-0212-z
  14. Roepke RML, Besen BAMP, Daltro-Oliveira R, et al. Predictive performance for hospital mortality of SAPS 3, SOFA, ISS, and new ISS in critically ill trauma patients: a validation cohort study. J Intensive Care Med. 2024;39(1):44-51. doi:10.1177/08850666231188051
  15. McCarthy SL, Stewart L, Shaikh F, Murray CK, Tribble DR, Blyth DM. Prognostic value of Sequential Organ Failure Assessment (SOFA) score in critically-ill combat-injured patients. J Intensive Care Med. 2022;37(11): 1426-1434. doi:10.1177/08850666221078196
  16. Aukema TS, Beenen LF, Hietbrink F, Leenen LP. Validation of the Thorax Trauma Severity Score for mortality and its value for the development of acute respiratory distress syndrome. Open Access Emerg Med. 2011;3:49-53. doi:10.2147/OAEM.S22802
  17. Bayer J, Lefering R, Reinhardt S, et al. Thoracic trauma severity contributes to differences in intensive care therapy and mortality of severely injured patients: analysis based on the TraumaRegister DGU®. World J Emerg Surg. 2017;12:43. doi:10.1186/s13017-017-0154-1
  18. Hefny AF, Elkamhawy AA, Fathi SA, Zoubeidi T, Alshamsi F. Outcomes and predictors of mortality in patients with blunt chest trauma admitted to the intensive care unit: a retrospective study. Front Med (Lausanne). 2025;12:1601033. doi:10.3389/fmed.2025.1601033
  19. Carelse NZ, Piovesan S, Davids R. Evaluation of the APACHE II as a mortality scoring system among intensive care unit polytrauma patients at a tertiary hospital in South Africa. Trauma. 2026;28(2-3):103-114. doi:10.1177/14604086261435148
  20. Lee MA, Choi KK, Yu B, et al. Acute Physiology and Chronic Health Evaluation II Score and Sequential Organ Failure Assessment Score as predictors for severe trauma patients in the intensive care unit. Korean J Crit Care Med. 2017;32(4):340-346. doi:10.4266/kjccm.2017.00255.
  21. Abramson D, Scalea TM, Hitchcock R, Trooskin SZ, Henry SM, Greenspan J. Lactate clearance and survival following injury. J Trauma. 1993;35(4):584-588. doi:10.1097/00005373-199310000-00014
  22. Régnier MA, Raux M, Le Manach Y, et al. Prognostic significance of blood lactate and lactate clearance in trauma patients. Anesthesiology. 2012;117(6):1276-1288. doi:10.1097/ALN.0b013e318273349d
  23. Cerović O, Golubović V, Spec-Marn A, Kremzar B, Vidmar G. Relationship between injury severity and lactate levels in severely injured patients. Intensive Care Med. 2003;29(8):1300-1305. doi:10.1007/s00134-003-1753-8
  24. Andersen LW, Mackenhauer J, Roberts JC, Berg KM, Cocchi MN, Donnino MW. Etiology and therapeutic approach to elevated lactate levels. Mayo Clin Proc. 2013;88(10):1127-1140. doi:10.1016/j.mayocp.2013.06.012