Predicting mortality in penetrating thoracic trauma in the emergency department: The prognostic value of the glucose-to-potassium ratio

BACKGROUND: Penetrating thoracic injuries are critical conditions that significantly influence the clinical outcomes of trauma patients in the emergency department (ED). This study evaluates the prognostic value of the glucose-to-potassium ratio (GPR) in predicting mortality among patients presenting to the ED with isolated penetrating thoracic injuries caused by stabbings.
METHODS: This retrospective cohort study was conducted in the emergency department of a tertiary hospital from January 1, 2021 to January 1, 2023. It includes patients diagnosed with isolated penetrating thoracic injuries resulting from stabbings. A database analysis was performed using patient records documenting demographic information, clinical findings, laboratory results, and outcomes.
RESULTS: Among the 88 patients included in the study, categorized into deceased (14.8%, n=13) and survivors (85.2%, n=75), the median glucose level was significantly higher in the deceased group (168 [interquartile range, IQR 145-229 mg/dL]) compared to the survivor group (126 [IQR 111-151 mg/dL]) (p<0.001). Conversely, potassium levels were lower in the deceased group (3.3 [IQR 3.01-3.82] mEq/L) compared to the survivor group (3.87 [IQR 3.5-4.18] mEq/L) (p=0.007). The GPR was higher in the deceased group (51.6 [IQR 42-75.1], p<0.001) than in survivors (32.6 [IQR 29-54.8]). The area under the receiver operating characteristic (AUROC) for the GPR in predicting mortality was 0.831 (95% confidence interval [CI] 0.736-0.903). With a cutoff value of ≥40.23, the sensitivity was 84.62% (95% CI 54.6-98.1), and the specificity was 78.67% (95% CI 67.7-87.3).
CONCLUSION: Our findings indicate that the GPR is a valuable prognostic marker for mortality in patients with stabbing-induced penetrating thoracic injuries presenting to the ED. This highlights its potential utility in early risk stratification within this patient population.

Penetran torasik travmalarda mortaliteyi öngörme: Acil serviste glukoz-potasyum oranýnýn prognostik deðeri

AMAÇ: Penetran torasik yaralanmalar, acil servisteki (AS) travma hastalarýnýn klinik sonuçlarýný önemli ölçüde etkileyen kritik durumlardýr. Bu çalýþma, AS'ye býçaklanma nedeniyle izole penetran torasik yaralanmalarla baþvuran hastalarda glukoz/potasyum oraný’nýn (GPR) mortaliteyi öngörmedeki prognostik deðerini deðerlendirmeyi amaçlamaktadýr.
GEREÇ VE YÖNTEM: Bu çalýþma, 1 Ocak 2021 ve 1 Ocak 2023 tarihleri arasýnda üçüncü basamak bir hastanenin acil servisinde gerçekleþtirilmiþtir. Retrospektif kohort çalýþmasý niteliðindeki bu araþtýrma, AS'de býçaklanmaya baðlý izole penetran torasik yaralanma tanýsý almýþ hastalarý içermektedir. Hasta dosyalarýnda kaydedilen demografik bilgiler, klinik bulgular, laboratuvar sonuçlarý ve sonuçlara dayalý bir veri tabaný analizi yapýlmýþtýr.
BULGULAR: Çalýþmadaki 88 hasta, ölenler (%14.8, n=13) ve hayatta kalanlar (%85.2, n=75) olarak iki gruba ayrýlmýþtýr. Ortanca glukoz seviyesi ölenlerde (168 [IQR 145–229 mg/dL], p<0.001) hayatta kalanlara göre (126 [IQR 111–151 mg/dL]) anlamlý derecede yüksekti; potasyum seviyesi ise hayatta kalanlarla kýyaslandýðýnda (3.87 [IQR 3.5 - 4.18] mEq/L) daha düþüktü (3.3 [IQR 3.01-3.82] mEq/L, p=0.007). GPR, ölenlerde (51.6 [IQR 42-75.1], p<0.001) hayatta kalanlara göre (32.6 [IQR 29 - 54.8]) daha yüksekti. Glukoz/potasyum oranýnýn mortaliteyi öngörmedeki AUROC deðeri 0.831 (95% CI 0.736–0.903) olarak bulundu. ≥40.23 eþik deðeri ile sensitivite %84.62 (95% CI 54.6–98.1), spesifisite %78.67 (95% CI 67.7–87.3) idi.
SONUÇ: Bulgularýmýz, GPR’nin, AS’ye býçaklanmaya baðlý penetran torasik yaralanmalarla baþvuran hastalarda mortalite için deðerli bir prognostik belirteç olarak hizmet ettiðini ve bu hasta popülasyonunda erken risk sýnýflandýrmasýnda potansiyel rolü olduðunu göstermektedir.