Glucose/potassium ratio as a prognostic marker in the emergency department for multiple trauma patients

Abstract

Aims: This study aimed to evaluate the prognostic value of the glucose-to-potassium ratio (GPR) measured at emergency department (ED) admission in patients with multiple trauma who required intensive care unit (ICU) follow-up. Methods: This retrospective study was conducted at a tertiary care center between January 1 and December 31, 2022. Adult patients admitted to the ED with multiple trauma and subsequently transferred to the ICU were included. Demographic characteristics, trauma mechanisms, laboratory values, and ICU outcomes were recorded. The predictive value of GPR for ICU mortality was analyzed using receiver operating characteristic (ROC) curve analysis. Additional comparisons were made with established biomarkers such as lactate and injury severity score (ISS). Results: A total of 253 patients met the inclusion criteria. The most common trauma mechanisms were falls (45.7%) and traffic accidents (38.9%). Median GPR was significantly higher in non-survivors than in survivors [45.5 (30.5–63.6) vs. 31.6 (25.8-39.5), p=0.001]. ROC analysis yielded an area under the curve (AUC) of 0.712 for GPR. The optimal cut-off value was 66.9, with a sensitivity of 21% and specificity of 95%. In logistic regression analysis, GPR was identified as an independent predictor of mortality (p=0.004, Exp (B): 0.96). While lactate (AUC: 0.775) and ISS (AUC: 0.881) showed stronger predictive power, GPR remains a practical and accessible marker in the ED setting. Conclusion: GPR is a simple, rapid, and cost-effective biomarker that may contribute to early risk stratification in multiple trauma patients. Although it should not be used in isolation for clinical decision-making, it may serve as a valuable adjunct to established prognostic tools. Further prospective and multicenter studies are warranted to validate its clinical utility.

Keywords

• Glucose/potassium ratio
• multiple trauma
• intensive care unit
• prognosis

Acil serviste çoklu travma hastalarında prognostik bir belirteç olarak glikoz/potasyum oranı

Abstract

ÖZET Amaç: Bu çalışma, acil servis (AS) başvurusunda ölçülen glukoz/potasyum oranının (GPR), yoğun bakım ünitesinde (YBÜ) takip gerektiren multipl travmalı hastalardaki prognostik değerini değerlendirmeyi amaçlamıştır. Yöntem: Bu retrospektif çalışma, 1 Ocak–31 Aralık 2022 tarihleri arasında bir üçüncü basamak sağlık merkezinde yürütülmüştür. Acil servise multipl travma ile başvuran ve ardından YBÜ’ye nakledilen erişkin hastalar çalışmaya dahil edilmiştir. Hastaların demografik özellikleri, travma mekanizmaları, laboratuvar değerleri ve YBÜ sonuçları kaydedilmiştir. GPR’nin YBÜ mortalitesini öngörmedeki değeri, ROC (alıcı işletim karakteristiği) eğrisi analizi ile değerlendirilmiştir. Ek olarak, laktat ve Travma Şiddet Skoru (ISS) gibi sık kullanılan biyobelirteçlerle karşılaştırmalar yapılmıştır. Bulgular: Çalışma kriterlerini karşılayan toplam 253 hasta analiz edildi. En yaygın travma mekanizmaları düşmeler (%45,7) ve trafik kazaları (%38,9) idi. Medyan GPR, hayatta kalamayan hastalarda hayatta kalanlara göre anlamlı derecede daha yüksekti [45,5 (30,5–63,6) vs. 31,6 (25,8–39,5), p=0,001]. ROC analizi sonucunda GPR için eğri altında kalan alan (AUC) 0,712 olarak bulundu. En uygun eşik değeri 66,9 olup, bu değerde duyarlılık %21 ve özgüllük %95 idi. Lojistik regresyon analizinde GPR, mortalitenin bağımsız bir yordayıcısı olarak belirlendi (p=0,004, Exp(B): 0,96). Laktat (AUC: 0,775) ve ISS (AUC: 0,881) daha güçlü öngörücü performans göstermesine rağmen, GPR acil servis koşullarında pratik ve ulaşılabilir bir belirteç olarak önemini korumaktadır. Sonuç: GPR, basit, hızlı ve maliyeti düşük bir biyobelirteç olup, multipl travmalı hastalarda erken risk sınıflandırmasına katkı sağlayabilir. Klinik karar verme sürecinde mevcut prognostik araçlara yardımcı bir parametre olarak değerlendirilebilir. Klinik kullanımını doğrulamak amacıyla daha ileri düzeyde prospektif ve çok merkezli çalışmalara ihtiyaç vardır.

Keywords

• Glikoz/potasyum oranı
• çoklu travma
• yoğun bakım
• prognoz

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