James W Davis1, Rachel C Dirks2, Krista L Kaups3, Phu Tran4. 1. UCSF Fresno Department of Surgery, Department of Surgery 1st Floor, 2823 Fresno St., Fresno, CA 93721, USA. Electronic address: jdavis@fresno.ucsf.edu. 2. UCSF Fresno Department of Surgery, Department of Surgery 1st Floor, 2823 Fresno St., Fresno, CA 93721, USA. Electronic address: rdirks@communitymedical.org. 3. UCSF Fresno Department of Surgery, Department of Surgery 1st Floor, 2823 Fresno St., Fresno, CA 93721, USA. Electronic address: kkaups@fresno.ucsf.edu. 4. UCSF Fresno Department of Surgery, Department of Surgery 1st Floor, 2823 Fresno St., Fresno, CA 93721, USA. Electronic address: ptran@fresno.ucsf.edu.
Abstract
BACKGROUND: Base Deficit (BD) and lactate have been used as indicators of shock and resuscitation. This study was done to determine the association of BD and lactate and to determine if one is superior. METHODS: A retrospective review from 3/2014-12/2016 was performed. Data included demographics, systolic BP, ISS, BD, lactate, blood transfusion, and outcomes. BD and lactate were modeled continuously and categorically and compared. RESULTS: 1191 patients were included. BD and lactate correlated strongly (r = -0.76 p < 0.001). Higher lactate and more negative BD were associated with transfusion and mortality. On multivariate regression, only BD was associated with transfusion (OR = 0.8, p < 0.001). As a categorical variable, worsening BD was associated with decreased BP, higher ISS, increased transfusions and worse outcomes. CONCLUSIONS: BD and lactate are strongly related. BD was superior to lactate in assessing the need for transfusion. The BD categories discriminate high risk trauma patients better than lactate.
BACKGROUND: Base Deficit (BD) and lactate have been used as indicators of shock and resuscitation. This study was done to determine the association of BD and lactate and to determine if one is superior. METHODS: A retrospective review from 3/2014-12/2016 was performed. Data included demographics, systolic BP, ISS, BD, lactate, blood transfusion, and outcomes. BD and lactate were modeled continuously and categorically and compared. RESULTS: 1191 patients were included. BD and lactate correlated strongly (r = -0.76 p < 0.001). Higher lactate and more negative BD were associated with transfusion and mortality. On multivariate regression, only BD was associated with transfusion (OR = 0.8, p < 0.001). As a categorical variable, worsening BD was associated with decreased BP, higher ISS, increased transfusions and worse outcomes. CONCLUSIONS: BD and lactate are strongly related. BD was superior to lactate in assessing the need for transfusion. The BD categories discriminate high risk traumapatients better than lactate.
Authors: Bjoern Zante; Hermann Reichenspurner; Mathias Kubik; Stefan Kluge; Joerg C Schefold; Carmen A Pfortmueller Journal: PLoS One Date: 2018-10-05 Impact factor: 3.240