DOI: 10.32322/jhsm.1959492 ISSN: 2636-8579

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

Burcu Ancın, Kemal Yetiş Gülsoy
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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

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