Prognostic value of 2-hour lactate level and lactate clearance for 30-day mortality and comparison with trauma scores in multi-trauma patients

Altunbas E., Omercikoglu S., Akoglu H., Denizbasi A.

Pakistan Journal of Medical Sciences, cilt.34, sa.3, ss.676-681, 2018 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 34 Sayı: 3
  • Basım Tarihi: 2018
  • Doi Numarası: 10.12669/pjms.343.14294
  • Dergi Adı: Pakistan Journal of Medical Sciences
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.676-681
  • Anahtar Kelimeler: Lactate, Lactate clearance, Trauma score, long term mortality, EARLY WARNING SCORE, BLOOD-PRESSURE SCORE, ILL MEDICAL PATIENTS, GLASGOW COMA SCALE, EMERGENCY-DEPARTMENT, VIEWS, PREDICT, AGE
  • Marmara Üniversitesi Adresli: Evet

Özet

Objective: Trauma scores are prone to misreading. Therefore, a readily available, objective way to estimate the mortality of the trauma patients is needed. We aimed to evaluate the prognostic utility of lactate levels, and clearance for 30-days mortality, and compare with the physiological trauma scores. Methods: All adult trauma patients (two hundred) admitted to ED were enrolled. Initial and 2-hour serum lactate levels were measured and components of GAP, MGAP, RTS, VIEWS and VIEWS-L trauma scores were calculated. Results: Final study population was 200 patients with a median age of 33 years. Mortality was 7/200 (3.5%) in 30-days. Both initial (2.3 vs. 7.7 mmol/L) and 2h-lactate (1.7 vs. 8.4 mmol/L) levels were significantly lower, and lactate clearance was significantly higher (23.8% vs.-12.0%) in survivors. Also, the change in the lactate level from 0h to 2h (2.3 vs. 1.7mmol/L) was significant in survivors, contrary to non-survivors (7.7 vs. 8.4mmol/L). VIEWS-L, VIEWS, two hour-lactate level and EMTRAS showed high specificity at the 100% sensitivity cut-offs, therefore, were the most valuable prognostic parameters in this study. Conclusion: Calculation of 2h-lactate clearance and evaluation of a 2h-lactate level may not be needed to predict long-term mortality if the initial lactate level is below 2.8mmol/L.