The Efficacy of Blood Lactate on Predicting the Prognosis of Patients with Multiple Trauma

Abstract

Introduction:

Because of the rapid progress of multiple trauma patients, the early mortality rate is high. Therefore, early assessment of the severity and prognosis of multiple injuries is crucial for timely treatment and improvement of prognosis. So we need to find parameters related to mortality and severity of multiple trauma.

Aim:

To find out parameters related to mortality and severity of multiple trauma.

Methods:

This was a single center, trauma registry based, observational cohort study. Data were collected from consecutive patients with multiple trauma who presented to the emergency department of a tertiary referral hospital between April 2015 and December 2016. The main outcomes studied were 28-day in-hospital mortality, 24-hours mortality, emergency operation rate, and ICU admission rate.

Results:

444 patients were eventually included in the study, including 337 males (75.9%) and 107 females (24.1%). The 28-day survival group consisted of 381 patients (85.8%) and the death group accounted for the other 14.2%. Multivariate logistic regression analysis showed that heart rate, peripheral oxygen saturation, lactic acid, partial pressure of carbon dioxide, plasma albumin, hematocrit, and Glasgow score were independent risk factors for 28-day mortality. The area under the ROC curve (AUC) of the above indicators was 0.669, 0.547, 0.868, 0.512, 0.740, 0.627, and 0.815, and the AUC value of lactate was the maximum.

Discussion:

When the body suffers from severe trauma, it loses a lot of blood and reduces the circulating blood volume, which leads to absolutely insufficient hemoglobin content and hypoxia of tissue cells. The plasma lactate content increases at this time. Therefore, lactate can be used as an important prognostic parameter for patients with multiple trauma. In addition, we can use lactate to revise the existing trauma score to enhance its effectiveness.