Main Article Content
Abstract
Introduction: Blunt thoracic trauma is a leading cause of trauma-related mortality. Early and accurate risk stratification is essential for optimizing outcomes, yet many prognostic scores lack validation in diverse populations. This study aimed to perform a preliminary evaluation of the prognostic value of the lung organ failure score (LOFS) for predicting in-hospital mortality in patients with blunt thoracic trauma in an Indonesian tertiary trauma center.
Methods: This retrospective, single-center, exploratory cohort study included adult patients (≥18 years) admitted with blunt thoracic trauma to Dr. Mohammad Hoesin General Hospital from January 2023 to January 2025. Data on demographics, injury characteristics, initial physiological parameters, and clinical outcomes were collected. The LOFS was calculated for each patient. The primary outcome was in-hospital mortality. Statistical analyses included bivariate comparisons, Kendall's Tau correlation, and Receiver Operating Characteristic (ROC) curve analysis.
Results: A total of 32 patients were included. The overall in-hospital mortality rate was 21.9% (n=7). The non-survivor group had a significantly higher mean LOFS than the survivor group (21.00±5.29 vs. 14.16±3.92, p=0.001). LOFS demonstrated a moderate, positive correlation with mortality (Kendall's Tau r=+0.568, p=0.001). ROC analysis showed that LOFS had excellent discriminative ability for mortality, with an Area Under the Curve (AUC) of 0.840 (95% CI: 0.685–0.995, p=0.001). An optimal cut-off score of ≥18 yielded a sensitivity of 85.7% and a specificity of 80.0%.
Conclusion: In this preliminary study, LOFS was strongly associated with in-hospital mortality and demonstrated excellent discriminative performance. The findings suggest LOFS is a promising and simple tool for early risk stratification in this high-risk population. However, the study's small sample size precluded a reliable assessment of its independence from other risk factors. Further validation in larger, prospective multicenter studies is essential to confirm these findings.
Keywords
Article Details
1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2.Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3.Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.