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Turkish Journal of Medical Sciences

Abstract

Background/aim: Thoracic trauma accounts for approximately 25% of all trauma-related deaths and remains a significant public health challenge. Early identification of high-risk patients is essential for improving clinical outcomes. The present study evaluates the prognostic value of the lactate dehydrogenase-to-albumin ratio (LDAR) in predicting 28-day mortality in patients with thoracic trauma.

Materials and methods: This retrospective observational study was conducted at a Level 1 trauma center between September 2022 and February 2025, and included adult patients presenting with thoracic trauma who underwent thoracic computed tomography. Demographic characteristics, clinical parameters, laboratory values, and 28-day mortality were analyzed. Receiver operating characteristic (ROC) curve analysis was performed to assess the discriminatory power of LDAR and other biomarkers, while multivariate logistic regression was used to identify independent predictors of mortality.

Results: A total of 493 patients were included in the study, 46 of whom (9.3%) died within 28 days. White blood cell count, lactate dehydrogenase, lactate, lactate/albumin ratio, LDAR, and Shock Index were statistically higher in the nonsurvivor group, and albumin, pH, and HCO3 levels were lower (p < 0.001). Furthermore, LDAR was significantly higher in the nonsurvivor group when compared to the survivors (13.51 vs. 7.48, p < 0.001). ROC analysis demonstrated that LDAR had excellent discriminatory power for predicting mortality (AUC = 0.854; 95% CI: 0.795–0.914), with an optimal cutoff value of 11.56 yielding 71.7% sensitivity and 91.5% specificity.

Conclusion: LDAR is a reliable and independent prognostic biomarker for predicting in-hospital mortality in patients with thoracic trauma. As a ratio derived from routine laboratory parameters without additional cost, LDAR offers a practical tool for rapid risk stratification and triage optimization in emergency settings. Prospective multicenter studies are warranted to validate these findings.

Author ORCID Identifier

ÖZGÜR ÖMERÖZGÜR YILDIZ: 0000-0001-7314-3131

ŞÜKRÜ YORULMAZ: 0000-0003-1685-4660

ERAY ÇINAR: 0000-0002-4564-6097

HÜSEYİN MUTLU: 0000-0002-1930-3293

RAMİZ YAZICI: 0000-0001-9210-914X

AYŞENUR GÜR: 0000-0002-9521-1120

MEDİNE AKKAN ÖZ: 0000-0002-6320-9667

BENSU BULUT: 0000-0002-5629-3143

MUSTAFA SIRRI KOTANOĞLU: 0000-0002-6906-573X

HAKAN GÜNER: 0000-0001-7045-3206

DOI

10.55730/1300-0144.6358

Keywords

biomarker, emergency medicine, LDAR, mortality prediction, Thoracic trauma

First Page

1141

Last Page

1151

Publisher

The Scientific and Technological Research Council of Türkiye (TÜBİTAK)

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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