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

Abstract

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.