The role of systemic inflammatory response index (SIRI), systemic inflammatory index (SII) and revised trauma score (RTS) in prediction of mortality in trauma patients

Objective: Trauma is a leading cause of mortality and morbidity, especially among young adults. This study aimed to assess the relationship between demographics, clinical findings, laboratory parameters, and prognostic scores on mortality in trauma patients admitted to the ICU. Materials and Methods: This retrospective study included 126 trauma patients (aged 18–75) admitted to the Anesthesiology and Reanimation ICU at Gaziantep University from March 2020 to March 2025. Data on demographics, trauma sites, ICU stay, mechanical ventilation, vital signs, lab results, and clinical scores (APACHE II, GCS, RTS, SIRI, SII) were analyzed. Survivors and non-survivors were compared statistically (p<0.05). Results: The average age was 40.9±20.1 years, with 72.2% male. The survival rate was 50%. Common trauma sites were lower (34.9%) and upper extremities (30.9%). Mechanical ventilation was needed in 65.9% of cases, and all non-survivors required it (p=0.001). Non-survivors had a longer ICU stay (p=0.044). Elevated lactate, hypoalbuminemia, and liver enzyme increases were linked to mortality. APACHE II, GCS, and RTS scores correlated with worse outcomes, while SII was higher in survivors (p=0.011). Conclusion: Key predictors of mortality in trauma patients included the need for mechanical ventilation, longer ICU stay, high APACHE II scores, low GCS, and low RTS. Elevated lactate, low albumin, and higher inflammatory markers were also significant. Early use of clinical scoring systems could aid in predicting outcomes. When the results of our study are compared with the literature, it is clearly evident that RTS is a strong predictor of mortality. However, the association between SII and survival partially diverges from the existing literature. As for SIRI, it has not emerged as an independent determinant of mortality prediction, neither in our study nor in some of the literature data. Keywords: Trauma, intensive care, mortality, APACHE II, inflammatory indices