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

Ching Hua Tsai, Ting Min Hsieh, Shiun Yuan Hsu, Ching Hua Hsieh*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review


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.

Original languageEnglish
Pages (from-to)879-887
Number of pages9
JournalRisk Management and Healthcare Policy
StatePublished - 2023

Bibliographical note

© 2023 Tsai et al.


  • ALT
  • AST
  • De Ritis ratio
  • alanine aminotransferase
  • aspartate aminotransferase
  • in-hospital mortality
  • trauma


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