The predictive value of hematologic parameters for adverse clinical outcomes in Earthquake-Related trauma patients: A...

This study aimed to evaluate whether the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) can reliably predict adverse clinical outcomes in earthquake-related trauma patients admitted to the emergency department.

This retrospective study included adult trauma patients presenting to Mersin University Hospital between February 6 and 20, 2023. Demographic variables, admission laboratory values, and adverse clinical outcomes-including rhabdomyolysis, acute compartment syndrome (ACS), crush syndrome (CS), acute kidney injury (AKI), dialysis requirement, fasciotomy, and amputation-were recorded. The predictive performance of NLR, PLR, and MPV was assessed using receiver operating characteristic (ROC) analysis.

A total of 531 patients were included. NLR demonstrated the strongest discriminatory ability across all adverse outcomes, with AUC values of 0.897 for AKI, 0.866 for dialysis, 0.836 for amputation, 0.820 for ACS, 0.785 for fasciotomy, and 0.762 for rhabdomyolysis. PLR showed moderate predictive accuracy for rhabdomyolysis (AUC = 0.574), ACS (AUC = 0.609), amputation (AUC = 0.667), CS (AUC = 0.580), and AKI (AUC = 0.616). MPV demonstrated significant predictive value only for CS (AUC = 0.597) and AKI (AUC = 0.616). Overall, NLR consistently outperformed PLR and MPV.

Hematological biomarkers-particularly NLR-provide meaningful prognostic value for identifying major adverse outcomes in post-disaster trauma. Their rapid availability, low cost, and ease of implementation support their use in early clinical decision-making and resource allocation in disaster-related emergency care.