Samuel W Ross1, Bradley W Thomas2, A Britton Christmas3, Kyle W Cunningham4, Ronald F Sing5. 1. Division of Acute Care Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA. Electronic address: Samuel.Ross@carolinashealthcare.org. 2. Division of Acute Care Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA. Electronic address: Bradley.Thomas@carolinashealthcare.org. 3. Division of Acute Care Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA. Electronic address: Ashley.Christmas@carolinashealthcare.org. 4. Division of Acute Care Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA. Electronic address: Kyle.Cunningham@carolinashealthcare.org. 5. Division of Acute Care Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA. Electronic address: Ronald.Sing@carolinashealthcare.org.
Abstract
INTRODUCTION: We hypothesized that a pH of <7.0 on presentation would correlate with almost universal mortality in trauma patients. METHODS: A retrospective cohort study was performed on a Level I trauma center registry from 2013 to 2014. Hospital mortality was the primary outcome, which was compared by pH cohort (<7.0 or ≥7.0) using standard univariate statistics and multivariate logistic regression. RESULTS: There were 593 patients included in the analysis: 66 in <7.0, 527 in ≥7.0. Mortality was 3× higher in the <7.0 pH cohort (62.1 vs. 20.3%; p < 0.0001), however there was no threshold for a pH below which there was 100% mortality. After controlling for these confounding variables, initial pH was found to be an independent predictor of inpatient mortality: pH < 7.0 (OR 6.33, 3.29-12.19; p < 0.0001). CONCLUSION: This data indicates that while patients with severe acidosis are at increased risk for mortality, a pH < 7.0 is still recoverable in select cases.
INTRODUCTION: We hypothesized that a pH of <7.0 on presentation would correlate with almost universal mortality in traumapatients. METHODS: A retrospective cohort study was performed on a Level I trauma center registry from 2013 to 2014. Hospital mortality was the primary outcome, which was compared by pH cohort (<7.0 or ≥7.0) using standard univariate statistics and multivariate logistic regression. RESULTS: There were 593 patients included in the analysis: 66 in <7.0, 527 in ≥7.0. Mortality was 3× higher in the <7.0 pH cohort (62.1 vs. 20.3%; p < 0.0001), however there was no threshold for a pH below which there was 100% mortality. After controlling for these confounding variables, initial pH was found to be an independent predictor of inpatient mortality: pH < 7.0 (OR 6.33, 3.29-12.19; p < 0.0001). CONCLUSION: This data indicates that while patients with severe acidosis are at increased risk for mortality, a pH < 7.0 is still recoverable in select cases.