Lee HY, Lee SM, Jeung KW, et al. - Researchers here conducted this work to determine for the first time the prognostic value of the ion shift index (ISI) for severe trauma. Per their hypothesis, there is a correlation of initial ISI measured in the emergency department (ED) with discharge survival in severe non-isolated head injury (IHI) patients. In this retrospective observational study, 483 severe non-IHI trauma patients were included. Of these patients, death was recorded for 86 patients (17.8 %). Non-IHI trauma patients with an ISS of 16 or higher showed association of initial ISI with mortality. Multiple logistic regression analysis demonstrated that in non-IHI trauma patients, following were the independently associated variables for the prediction of mortality: the ISI, trauma and injury severity score, lactate, creatinine, and activated partial thromboplastin time. The AUROC for the multiple logistic regression model employing laboratory variables that were significantly linked with mortality established excellent prognostic performance and significantly higher than that of the model without ISI. Overall findings suggest that ISI could be employed as an early prognostic marker in conjunction with other prognostic indicators, particularly if TRISS is unavailable.