Prognostic Value of Inflammatory and Metabolic Biomarkers in ICU-Admitted Trauma Patients: A Retrospective Cohort Study

Background and Objectives: Prognostic stratification in trauma patients admitted to the intensive care unit (ICU) remains a clinical challenge. While conventional scoring systems such as Acute Physiology and Chronic Health Evaluation II (APACHE II), Injury Severity Score (ISS), and Glasgow Coma Scale (GCS) are widely used, the utility of biochemical biomarkers in predicting mortality is still evolving. This study aimed to evaluate the prognostic value of key inflammatory and metabolic biomarkers: platelet-to-lymphocyte ratio (PLR), C-reactive protein-to-albumin ratio (CAR), serum lactate, base deficit, and neutrophil-to-lymphocyte ratio (NLR) in relation to ICU mortality in trauma patients. Materials and Methods: In this retrospective cohort study, data from 240 ICU-admitted trauma patients were analyzed. Group comparisons between survivors and non-survivors were conducted using t-tests or Mann–Whitney-U tests. Pearson correlation and ROC analyses were performed to assess relationships and discriminatory performance of biomarkers alongside clinical scores. Results: Non-survivors (n = 50) exhibited significantly higher CAR, lactate, and base-deficit values, and lower PLR (p < 0.05) compared to survivors (n = 190). CAR strongly correlated with CRP (r = 0.96), while lactate and base deficit were inversely correlated (r = –0.69). ROC analysis revealed that ISS (AUC = 0.86) and APACHE II (AUC = 0.77) had the highest discriminatory power, followed by lactate (AUC = 0.75). NLR did not demonstrate significant prognostic utility (p > 0.05). Conclusion: PLR, CAR, lactate, and base deficit are accessible, cost-effective biomarkers with significant prognostic value in ICU trauma care. Their integration with established scoring systems can enhance early risk stratification. NLR, however, may require time-sensitive and context-specific evaluation.