Acute and Critical Care

Original Articles

Trauma
Predictive value of initial lactate levels for mortality and morbidity in critically ill pediatric trauma patients: a retrospective study from a Turkish pediatric intensive care unit: Abdulrahman Özel, Esra Nur İlbeği, Servet Yüce; Acute Crit Care. 2025;40(1):87-94. Published online February 18, 2025; DOI: https://doi.org/10.4266/acc.003528

6,921 View
184 Download
4 Web of Science
5 Crossref

Background
This study investigated the relationship between initial lactate levels and both mortality and morbidity in critically ill pediatric trauma patients requiring intensive care.
Methods
This retrospective study at tertiary center’s pediatric intensive care unit from January 2020 to June 2024 aimed to characterize trauma patients and assess admission lactate levels' prognostic value.
Results
A total of 190 critically ill pediatric trauma patients were included in the study. The mortality rate was 7.9%, with most deaths occurring within the first 48 hours of admission. Initial lactate levels ≥6.9 mmol/L demonstrated moderate predictive power (area under the curve [AUC], 0.878) for mortality. Pediatric Risk of Mortality III (PRISM III) score showed good predictive ability (AUC, 0.922), while Pediatric Trauma Scores exhibited variable predictive performance (AUC, 0.863). Higher initial lactate levels were significantly associated with severe brain injury, the need for intubation, and an increased incidence of thoracic or abdominal injuries.
Conclusions
Initial lactate levels and PRISM III score are effective predictors of mortality in critically ill pediatric trauma patients. Lactate levels ≥5 mmol/L upon admission should prompt close monitoring and consideration of aggressive management strategies.

Citations

Citations to this article as recorded by

Beyond survival: Early markers of poor outcome in pediatric trauma
Kubra Boydag Guvenc, Ebru Guney Sahin, Idris Abdullah Yılmaz, Refik Ozturk, Ceyhan Sahin, Fatih Varol, Cansu Durak
The American Journal of Emergency Medicine.2026; 101: 103. CrossRef
PIM2, lactate, and trauma score to predict mortality in critically ill pediatric trauma patients
Luciana G. Barcellos, Fernanda M. Rubin, Ana Paula P. da Silva, Júlia L. Vieira, Luciane G. da Cunha, Lucinara V. Enéas Machado, Geniara da S. Conrado, Cristian T. Tonial
Jornal de Pediatria.2026; 102(2): 101509. CrossRef
Prognostic value of lactate-to-albumin ratio and inflammatory indices in pediatric traumatic brain injury: A comparative study with PRISM III
Özlem Bostan Gayret, Abdulrahman Özel, Servet Yüce, Harun Çatak, Selen Mandel Işikli, Meltem Erol
Medicine.2026; 105(8): e47689. CrossRef
Incidence, severity and outcomes of hypoxemia in paediatric emergencies seen at a tertiary hospital in Southern Nigeria
Moses T. Abiodun, Gabriel Oziegbe, Imuwahen A. Mbarie, Wilson O. Osarogiagbon, Collins E. Etin-Osa, Rosena O. Oluwafemi, Godwin E. Okungbowa, Ovonomo Ewhe, Rahmon Olusola, Benjamin Nandom, Adesuwa Kpongo-Ogieva, Jane Aghama, Cyril Oputa
International Journal of Contemporary Pediatrics.2025; 12(8): 1289. CrossRef
Prognostic value of the lactate dehydrogenase-to-albumin ratio for predicting mortality in critically ill pediatric patients: a retrospective cohort study
Ming Liu, Yunpeng Gou, Ping Yang
Frontiers in Pediatrics.2025;[Epub] CrossRef

Trauma
Role of platelet-to-lymphocyte ratio at the time of arrival to the emergency room as a predictor of short-term mortality in trauma patients with severe trauma team activation: Jae Kwang Kim, Kyung Hoon Sun; Acute Crit Care. 2024;39(1):146-154. Published online February 15, 2024; DOI: https://doi.org/10.4266/acc.2023.01319

10,696 View
290 Download
5 Web of Science
8 Crossref

Abstract PDF

Background
Platelet-to-Lymphocyte ratio (PLR) has been studied as a prognostic factor for various diseases and traumas. This study examined the utility of PLR as a tool for predicting 30-day mortality in patients experiencing severe trauma.
Methods
This study included 139 patients who experienced trauma and fulfilled ≥1 criteria for activation of the hospital’s severe trauma team. Patients were divided into non-survivor and survivor groups. Mean PLR values were compared between the groups, the optimal PLR cut-off value was determined, and mortality and survival analyses were performed. Statistical analyses were performed using SPSS ver. 26.0. The threshold of statistical significance was P<0.05.
Results
There was a significant difference in mean (±standard deviation) PLR between the non-survivor (n=36) and survivor (n=103) groups (53.4±30.1 vs. 89.9±53.3, respectively; P<0.001). Receiver operating characteristic (ROC) curve analysis revealed an optimal PLR cut-off of 65.35 (sensitivity, 0.621; specificity, 0.694, respectively; area under the ROC curve, 0.742), and Kaplan-Meier survival analysis revealed a significant difference in mortality rate between the two groups.
Conclusions
PLR can be calculated quickly and easily from a routine complete blood count, which is often performed in the emergency department for individuals who experience trauma. The PLR is useful for predicting 30-day mortality in trauma patients with severe trauma team activation.

Citations

Citations to this article as recorded by

Key laboratory changes in severe trauma, a different pattern for each clinical phenotype
Adrián Marcos-Morales, Jesús Abelardo Barea Mendoza, Marcos Valiente Fernández, Carlos García Fuentes, Fernando Calvo Boyero, Cecilia Cueto-Felgueroso, Judith Gutiérrez Gutiérrez, Francisco de Paula Delgado Moya, Carolina Mudarra Reche, Susana Bermejo Azn
Medicina Intensiva (English Edition).2026; 50(4): 502227. CrossRef
Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Combined with Model for End-Stage Liver Disease 3.0 as a Prognostic Predictor for Patients with Liver Cirrhosis after Transjugular Intrahepatic Portosystemic Shunt Creation
Takeshi Suzuki, Kenkichi Michimoto, Kentaro Yamada, Khashayar Farsad
Journal of Vascular and Interventional Radiology.2026; 37(2): 107922. CrossRef
Stabilized C-reactive protein–albumin–lymphocyte (CALLY) index predicts adjacent fractures after kyphoplasty
Chunbiao Deng, Haiqiao Huang, Linlin Chen, Xin Chen, Qian Chen, Yougang Liao, Shuliang Li
BMC Musculoskeletal Disorders.2026;[Epub] CrossRef
Key laboratory changes in severe trauma, a different pattern for each clinical phenotype
Adrián Marcos-Morales, Jesús Abelardo Barea Mendoza, Marcos Valiente Fernández, Carlos García Fuentes, Fernando Calvo Boyero, Cecilia Cueto-Felgueroso, Judith Gutiérrez Gutiérrez, Francisco de Paula Delgado Moya, Carolina Mudarra Reche, Susana Bermejo Azn
Medicina Intensiva.2026; 50(4): 502227. CrossRef
Utility of platelet- to lymphocyte ratio as an inflammatory biomarker in major burns. our experience
Dayamí Zaldívar Castillo MD, Néstor Nemer Pérez MD, Carlos Lora Buelvas MD, Adelmo de J González Méndez MD, Freddy J Cruz Reyes MD, Yaqueline Castellanos MD
Journal of Anesthesia & Critical Care: Open Access.2025; 17(1): 1. CrossRef
The predictors of prognostic nutritional index and its association with in-hospital mortality among critically ill geriatric patients
Khalid Elsayed Elsorady, Ahmed Ahmed Mohamed Abotaha, Mohammed Abdelmoaty Ebrahim Shaheen, Hisham Ahmed Hani Mostafa Abdelaziz, Essam Yehia Ali Aggour, Mohamed Elwan Mohamed Mahmoud
Electronic Journal of General Medicine.2025; 22(4): em656. CrossRef
Prognostic Value of Inflammatory and Metabolic Biomarkers in ICU-Admitted Trauma Patients: A Retrospective Cohort Study
Hasan Celik, Basak Pehlivan, Veli Fahri Pehlivan, Erdogan Duran
Medicina.2025; 61(9): 1530. CrossRef
Utility of systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio as a predictive biomarker in pediatric traumatic brain injury
Muhammad Arifin Parenrengi, Wihasto Suryaningtyas, Ahmad Data Dariansyah, Budi Utomo, Glenn Otto Taryana, Catur Kusumo, Surya Pratama Brilliantika
Surgical Neurology International.2024; 15: 456. CrossRef

Nephrology
Epidemiology and outcome of an acute kidney injuries in the polytrauma victims admitted at the apex trauma center in Dubai: Bhushan Sudhakar Wankhade, Zeyad Faoor Alrais, Ghaya Zeyad Alrais, Ammar Mohamed Abdel Hadi, Gopala Arun Kumar Naidu, Mohammed Shahid Abbas, Ahmed Tarek Youssef Aboul Kheir, Hasan Hadad, Sundareswaran Sharma, Mohammad Sait; Acute Crit Care. 2023;38(2):217-225. Published online May 25, 2023; DOI: https://doi.org/10.4266/acc.2023.00388

6,396 View
133 Download
1 Web of Science
2 Crossref

Abstract PDF

Background
Polytrauma from road accidents is a common cause of hospital admissions and deaths, frequently leading to acute kidney injury (AKI) and impacting patient outcomes.
Methods
This retrospective, single-center study included polytrauma victims with an Injury Severity Score (ISS) >25 at a tertiary healthcare center in Dubai.
Results
The incidence of AKI in polytrauma victims is 30.5%, associated with higher Carlson comorbidity index (P=0.021) and ISS (P=0.001). Logistic regression shows a significant relationship between ISS and AKI (odds ratio [OR], 1.191; 95% confidence interval [CI], 1.150–1.233; P<0.05). The main causes of trauma-induced AKI are hemorrhagic shock (P=0.001), need for massive transfusion (P<0.001), rhabdomyolysis (P=0.001), and abdominal compartment syndrome (ACS; P<0.001). On multivariate logistic regression AKI can be predicated by higher ISS (OR, 1.08; 95% CI, 1.00–1.17; P=0.05) and low mixed venous oxygen saturation (OR, 1.13; 95% CI, 1.05–1.22; P<0.001). The development of AKI after polytrauma increases length of stay (LOS)-hospital (P=0.006), LOS-intensive care unit (ICU; P=0.003), need for mechanical ventilation (MV) (P<0.001), ventilator days (P=0.001), and mortality (P<0.001).
Conclusions
After polytrauma, the occurrence of AKI leads to prolonged hospital and ICU stays, increased need for mechanical ventilation, more ventilator days, and a higher mortality rate. AKI could significantly impact their prognosis.

Citations

Citations to this article as recorded by

Normotensive trauma patients with renal injuries: Hidden candidates for massive transfusion
Xin‐Hong Lin, Pi‐Chieh Lin, Ching‐Hua Tsai, Wei‐Ti Su, Shiun‐Yuan Hsu, Ching‐Hua Hsieh
Hong Kong Journal of Emergency Medicine.2025;[Epub] CrossRef
Acute kidney injury in critically ill patients with traumatic brain injury: A single-center retrospective cohort study
Bhushan Sudhakar Wankhade, Mohamed Hamed Ibrahim Ali El Kholi, Zeyad Faoor Alrais, Adel Elsaid Salem Elkhouly, Gopala Arun Kumar Naidu, Alim Akbar Patel, Mohamed Sameer, Mohammed Shahid Abbas, Nowar Nouralla Fadol Elbasier, Aala Fadlalla El Hadi
World Journal of Critical Care Medicine.2025;[Epub] CrossRef

Trauma
Acute Physiology and Chronic Health Evaluation II Score and Sequential Organ Failure Assessment Score as Predictors for Severe Trauma Patients in the Intensive Care Unit: Min A Lee, Kang Kook Choi, Byungchul Yu, Jae Jeong Park, Youngeun Park, Jihun Gwak, Jungnam Lee, Yang Bin Jeon, Dae Sung Ma, Gil Jae Lee; Korean J Crit Care Med. 2017;32(4):340-346. Published online November 30, 2017; DOI: https://doi.org/10.4266/kjccm.2017.00255

13,601 View
199 Download
13 Web of Science
12 Crossref

Abstract PDF

Background
The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system and the Sequential Organ Failure Assessment (SOFA) scoring system are widely used for critically ill patients. We evaluated whether APACHE II score and SOFA score predict the outcome for trauma patients in the intensive care unit (ICU).
Methods
We retrospectively analyzed trauma patients admitted to the ICU in a single trauma center between January 2014 and December 2015. The APACHE II score was figured out based on the data acquired from the first 24 hours of admission; the SOFA score was evaluated based on the first 3 days in the ICU. A total of 241 patients were available for analysis. Injury Severity score, APACHE II score, and SOFA score were evaluated.
Results
The overall survival rate was 83.4%. The non-survival group had a significantly high APACHE II score (24.1 ± 8.1 vs. 12.3 ± 7.2, P < 0.001) and SOFA score (7.7 ± 1.7 vs. 4.3 ± 1.9, P < 0.001) at admission. SOFA score had the highest areas under the curve (0.904). During the first 3 days, SOFA score remained high in the non-survival group. In the non-survival group, cardiovascular system, neurological system, renal system, and coagulation system scores were significantly higher.
Conclusions
In ICU trauma patients, both SOFA and APACHE II scores were good predictors of outcome, with the SOFA score being the most effective. In trauma ICU patients, the trauma scoring system should be complemented, recognizing that multi-organ failure is an important factor for mortality.

Citations

Citations to this article as recorded by

Nutritional compliance as a prognostic and quality indicator in the intensive care unit: Insights from nutrition support team–guided therapy
Soo-Hyun Park, Jung Hwan Lee, Jongbeom Shin, Sunmin Lee, Jae Won Lee, Hyunjin Ju, Jeong-Yoon Lee, Kyungbok Lee
Nutrition.2026; 142: 112962. CrossRef
Development and validation of a machine learning model to predict 30-day mortality in ischemic stroke patients with consciousness impairment: Insights from MIMIC-IV database and multicenter ICU data in China
Yupei Cheng, Yang Guo, Yusheng Zhao, Chaoran Wang, Xiaoling Zhao, Qiuhua Yu, Jingjie Huang, Yuxing Zhang, Jingsha Zhang, Xixian Liu, Pan Cai, Chao Zhang, Bangqi Wu, Yi Guo
International Journal of Medical Informatics.2026; 207: 106203. CrossRef
Comparison of Braden Score vs APACHE to Predict Occurrence of Bed Sores in a Tertiary Care ICU
Sandeep Dewan, Munish Chauhan, Khuram Maqbool
Indian Journal of Critical Care Medicine.2025; 29(2): 164. CrossRef
Comparison of Serum Phosphate Levels in Critically Ill Patients with Acute Kidney Injury Undergoing Continuous Renal Replacement Therapy Using Different Dialysates
Moo Jun Kim, Hae Ri Kim, Young Rok Ham, Jae Wan Jeon
Journal of Kidney Diseases.2025; 19(02): 106. CrossRef
Comparison of APACHE II and APACHE IV Scores in Predicting Mortality in the Surgical ICU (SICU) of a Tertiary Care Hospital - A Prospective Study
Prashanta Swami Pujar, Pavithra P, Sachin ., Prajwal RK
International Journal of Health Sciences and Research.2025; : 192. CrossRef
Identification of TRIM52 as a potential biomarker in mortality risk assessment in patients with sepsis
Ke Wang, Zhubin Yang, Chun Xiang Wu, Ju Cao
Human Immunology.2024; 85(6): 111174. CrossRef
Clinical significance of lactate-to-albumin ratio in patients with influenza A virus-induced acute respiratory distress syndrome: a single-center retrospective study
Jinhui Gao, Xuanzhe Yang, Xiang Fang, Ziyi Zhang, Dapeng Wang, Jiajia Wang
BMC Anesthesiology.2024;[Epub] CrossRef
ATENDIMENTO PRÉ-HOSPITALAR AO TRAUMA E SEU DESFECHO INTRA-HOSPITALAR EM 72 HORAS
Paulo Philip de Abreu Gonzaga, Thiago Queiroz de Souza, Bárbara Juliana Carvalho Costa, Ivany Rolim Vinhote Teixeira, Gisele Torrente
Enfermagem em Foco.2024;[Epub] CrossRef
Cell-free DNA as diagnostic and prognostic biomarkers for adult sepsis: a systematic review and meta-analysis
Awirut Charoensappakit, Kritsanawan Sae-khow, Pongpera Rattanaliam, Nuntanuj Vutthikraivit, Monvasi Pecheenbuvan, Suwasin Udomkarnjananun, Asada leelahavanichkul
Scientific Reports.2023;[Epub] CrossRef
Evaluation of the sequential organ failure assessment score and newly introduced criteria – Traumasis - in traffic collision patients
Sion Jo, Taeoh Jeong, Boyoung Park
The American Journal of Emergency Medicine.2022; 51: 98. CrossRef
Predictive value of Modified Early Warning Score (MEWS) and Revised Trauma Score (RTS) for the short-term prognosis of emergency trauma patients: a retrospective study
Zhejun Yu, Feng Xu, Du Chen
BMJ Open.2021; 11(3): e041882. CrossRef
Risk factors for abdominal surgical site infection after exploratory laparotomy among combat casualties
Joseph D. Bozzay, Patrick F. Walker, David W. Schechtman, Faraz Shaikh, Laveta Stewart, M. Leigh Carson, David R. Tribble, Carlos J. Rodriguez, Matthew J. Bradley
Journal of Trauma and Acute Care Surgery.2021; 91(2S): S247. CrossRef

First
Prev
Page of 1
Next
Last

Search