Correlations of the Serum Lactate and the Base Deficit levels to Injury Severity in Trauma Patients

Seo, Jun Seok; Lee, Jeong Ho; Seol, Dong Hoan; Choe, Michael Sung Pil; Seo, Kang Suk; Park, Jeong Bae; Chung, Jae Myung; Kim, Kyu Tae

Abstract

PURPOSE
Although the Injury Severity Score (ISS) has certain predictive limitations and difficulties in calculation, the ISS has been widely used as a predictor of serious injury. The objective of this study was to determine the correlations of the serum lactate and base deficit levels to injury severity and to determine the value of using serum lactate and base deficit measurements as prognostic tools in the emergency department.
METHODS
This study was a retrospective analysis of data collected from March 2001 to February 2002, and two hundred seventeen trauma patients who were admitted to the Emergency Department (ED) of Kyungpook National University Hospital during that period were included in this study. Patients who received a transfusion, bicarbonate, or vasopressor or who had no ISS score were excluded from this study.
RESULTS
The serum lactate and the base deficit, as well as the ISS, showed a significant value for predicting the seriousness of injury in trauma patients. Because gamma(Pearson's correlation coefficient) between ISS and serum lactate levels is 0.890, it showed strong association. Especially, in multiple injury patients, the serum lactate level had predictive value in revealing hidden injuries that could lead to possible death. Logistic regression showed a strong association between the serum lactate and base deficit levels and mortality rate.
CONCLUSION
The serum lactate and the base deficit levels at admission to the ED are useful tools in predicting the outcome in severe trauma patients, and they can be used adjunct to previous injury scoring systems.