JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

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Original Article
Comparison of the lactate-to-albumin ratio, Shock index, and injury severity score for predicting in-hospital mortality among trauma patients presenting to the emergency department: a retrospective study
Abstract
Aims: Rapid and accurate risk stratification is vital in trauma care. This study compared the prognostic performance of the lactate-to-albumin ratio (LAR), the Shock Index (SI), and the Injury Severity Score (ISS) in predicting in-hospital mortality among adult trauma patients presenting to the emergency department (ED). Methods: Single-center retrospective cohort of consecutive adult (?18 years) trauma presentations to a tertiary ED (January 2022–January 2025). Cases with missing core variables were excluded. Discrimination for ICU admission, invasive mechanical ventilation, and in-hospital mortality was quantified by area under the ROC curve (AUC) with 95% CIs and compared pairwise using DeLong tests. Youden-optimized thresholds were summarized with positive/negative likelihood ratios, predictive values, and Youden’s J. In-hospital mortality associations were examined using univariable and prespecified multivariable logistic regression. Results: A total of 4.942 patients were included, and the in-hospital mortality rate was 3.1%. The ISS consistently performed better than the SI and the LAR. For intensive care unit (ICU) admission, the AUCs were 0.943 for ISS, 0.829 for SI, and 0.801 for LAR. For the need for mechanical ventilation, the AUCs were 0.938 for ISS, 0.813 for SI, and 0.788 for LAR. For in-hospital mortality, the AUCs were 0.851 for ISS, 0.763 for LAR, and 0.757 for SI. DeLong tests showed that ISS was significantly superior to both SI and LAR in predicting in-hospital mortality (p

Keywords : Trauma, lactate-to-albumin ratio, shock index, injury severity score, emergency department

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Article available in :
Volume 9, Issue 1, 2026
Page : 26-31
https://doi.org/10.32322/jhsm.1799259
Article Information
Received : 08 Eki 2025
Accepted : 11 Kas 2025
Published : 05 Oca 2026
Corresponding Author :

Hakan Aydın: Department of Emergency Medicine, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkiye

[email protected]
Citation : Acar AÖ, Aydın H. Comparison of the lactate-to-albumin ratio, Shock index, and injury severity score for predicting in-hospital mortality among trauma patients presenting to the emergency department: a retrospective study. J Health Sci Med. 2026;9(1):26-31. doi:10.32322/jhsm.1799259

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