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.