A High De Ritis Ratio is Associated with Mortality in Adult Trauma Patients

Abstract

Introduction The De Ritis ratio, which is the ratio of aspartate aminotransferase (AST) to alanine aminotransferase (ALT), has been suggested as a potential prognostic marker for various diseases. This study aimed to investigate the association between the De Ritis ratio and in-hospital mortality in adult trauma patients. Methods A total of 17,472 adult trauma patients hospitalized between January 1, 2009, and December 31, 2020, were allocated into groups according to the De Ritis ratio. The normal range of the De Ritis ratio was calculated from 3320 individuals in the National Taiwan Biobank. Statistical analyses were performed using SPSS software. Results Patients with a De Ritis ratio >1.6 had a significantly higher in-hospital mortality rate (7.3% vs 1.5%, odds ratio 5.29; Q1–Q3 2.72–10.30; p < 0.001) and a 2.71-fold higher in-hospital mortality rate (Q1–Q3 1.24–5.92; p = 0.012), after adjusting for sex, age, comorbidities, consciousness level, and injury severity, than those with a De Ritis ratio within the reference values. Discussion This study revealed that a De Ritis ratio >1.6 may serve as an early prognostic tool to identify adult trauma patients at high risk of in-hospital mortality.

Navigating Disease Management: A Comprehensive Review of the De Ritis Ratio in Clinical Medicine

“…In CVD, an elevated De Ritis ratio correlates positively with age, systemic inflammation, and impaired renal function and, inversely, with obesity, metabolic syndrome, and diabetes mellitus [7]. In adult trauma, a high De Ritis ratio has been associated with mortality and may serve as a proxy measure for ischemic end-organ damage [13]. In COVID-19, an elevated De Ritis ratio has been linked to disease severity and mortality [14].…”

“…In COVID-19, an elevated De Ritis ratio has been linked to disease severity and mortality [14]. The De Ritis ratio is a valuable biomarker in clinical medicine, providing useful information for risk evaluations and as a prognostic marker of in-hospital mortality in COVID-19 patients [13,14]. However, considering the reference range and underlying clinical condition, its interpretation should be made within the specific clinical context.…”

“…In COVID-19, a high De Ritis ratio has been associated with increased mortality [7,13]. One study found that patients with a De Ritis ratio ≥ 1.218 are more susceptible to liver damage and cytokine release syndrome [7].…”

“…In ALD, the De Ritis ratio can be as high as 2.30:1 in patients, compared to 1.10:1 in the control group, facilitating diagnosis [16]. This ratio is also helpful in distinguishing between various sources of liver disease and serves as an important predictive tool for mortality in adult trauma patients [13]. In chronic viral illnesses, such as chronic viral hepatitis and chronic alcoholism, an elevated AST/ALT ratio predicts long-term complications, including fibrosis and cirrhosis [4].…”

“…A high De Ritis ratio was associated with mortality in adult trauma patients, indicating its potential as a prognostic marker in this patient population. This association suggests that the De Ritis ratio could be essential in evaluating trauma cases' severity and potential outcomes, helping clinicians make more informed decisions about patient care and intervention strategies [13].…”