Inflammation Indıces and Mortality in Adult Crush Syndrome

Overview

This retrospective observational cohort study aims to evaluate the prognostic value of inflammatory hematological indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and pan-immune-inflammation value (PIV), in predicting 28-day mortality in adult patients with crush syndrome admitted to the intensive care unit (ICU). Patients aged 18 years and older diagnosed with crush syndrome between January 1, 2018, and September 30, 2025, were included. The primary outcome is 28-day mortality. Secondary outcomes include ICU mortality and in-hospital mortality. The predictive performance of inflammatory indices will be compared with established severity scores such as APACHE II and SOFA.

Crush syndrome is a life-threatening condition characterized by severe muscle injury, systemic inflammatory response, acute kidney injury, and high mortality, particularly in disaster-related mass trauma settings. Early risk stratification is crucial for optimizing intensive care management and resource allocation. This retrospective cohort study includes adult patients (≥18 years) diagnosed with crush syndrome and admitted to the intensive care unit of Ataturk University Hospital between January 1, 2018, and September 30, 2025. Demographic data, laboratory parameters, and clinical severity scores were obtained from electronic medical records. Inflammatory indices calculated from complete blood count parameters include: * Neutrophil-to-lymphocyte ratio (NLR) * Platelet-to-lymphocyte ratio (PLR) * Monocyte-to-lymphocyte ratio (MLR) * Systemic immune-inflammation index (SII) * Systemic inflammatory response index (SIRI) * Pan-immune-inflammation value (PIV) The primary endpoint is 28-day mortality following ICU admission. Secondary endpoints include ICU mortality and in-hospital mortality. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses will be performed to assess the independent prognostic value of inflammatory indices compared with established scoring systems such as APACHE II and SOFA. The study aims to determine whether readily available hematological indices provide additional prognostic value in critically ill patients with crush syndrome.