Novel Fibrinogen- and Procalcitonin-Based Composite Ratios for Mortality Prediction in Pediatric Trauma

Background

Composite biomarkers combining inflammatory or metabolic markers with a negative acute-phase protein predict outcomes in critically ill patients, but fibrinogen-based ratios grounded in the “lethal triad” of trauma-induced coagulopathy remain unexplored in pediatric trauma. We evaluated novel lactate/fibrinogen (LFR) and procalcitonin/fibrinogen (PFR) ratios alongside the procalcitonin/albumin ratio (PAR), a composite triple inflammation–perfusion index (TIPI, combining procalcitonin, CRP, and lactate relative to albumin), and established albumin-based ratios and severity scores for mortality prediction.