European Journal of Trauma and Emergency Surgery · Jun 10, 2026
Mortality prediction in older adults with earthquake-related trauma: a model combining MEWS and laboratory biomarkers
By Ozen A, Acehan S, Satar S et al.
PURPOSE: This study aimed to identify laboratory parameters and clinical scores that can predict in-hospital mortality among patients aged 65 years and older who presented to the emergency department (ED) with earthquake-related trauma following the February 6 and 20, 2023 earthquakes. METHODS: In this retrospective observational study, 362 patients with earthquake-related trauma between February 6-21, 2023, were included. Demographic characteristics, laboratory results, and clinical scores such as the Modified Early Warning Score (MEWS), Injury Severity Score (ISS), and Shock Index (SI) were analyzed. RESULTS: Of the included patients, 53.9% (n = 195) were female, and the median age was 73 years (IQR: 69-80). The overall mortality rate was 9.4%. Multivariable logistic regression analysis identified MEWS (OR: 3.535; 95% CI: 2.397-5.212; p < 0.001), urea (OR: 1.009; 95% CI: 1.002-1.015; p = 0.008), and hs-Troponin I (OR: 1.001; 95% CI: 1.000-1.002; p = 0.016) as independent predictors of mortality. Receiver operating characteristic (ROC) analysis demonstrated an AUC of 0.936 for the combined model including MEWS, urea, and hs-Troponin I (95% CI: 0.875-0.996; p < 0.001). Among the variables, MEWS showed the highest AUC (0.903; 95% CI: 0.829-0.976). The optimal cutoff value for MEWS was determined as 1.5, with a sensitivity of 70.6% and a specificity of 97.6%. CONCLUSIONS: In older adults with earthquake-related trauma, integrating laboratory parameters-particularly urea and hs-Troponin I-with MEWS substantially improves mortality prediction. These findings underscore the importance of early laboratory-based evaluation for accurate risk stratification in disaster settings.