Study of initial blood lactate and delta lactate as early predictor of morbidity and mortality in trauma patients
Azer, Z., Leone, M., Chatelon, J., Abulfatth, A., Ahmed, A., Saleh, R. (2023). Study of initial blood lactate and delta lactate as early predictor of morbidity and mortality in trauma patients. EKB Journal Management System, 39(1), 149-156. doi: TEJA-2022-0261
Zarif Azer; Marc Leone; Jeanne Chatelon; Amr Abulfatth; Ahmed Ahmed; Rabab Saleh. "Study of initial blood lactate and delta lactate as early predictor of morbidity and mortality in trauma patients". EKB Journal Management System, 39, 1, 2023, 149-156. doi: TEJA-2022-0261
Azer, Z., Leone, M., Chatelon, J., Abulfatth, A., Ahmed, A., Saleh, R. (2023). 'Study of initial blood lactate and delta lactate as early predictor of morbidity and mortality in trauma patients', EKB Journal Management System, 39(1), pp. 149-156. doi: TEJA-2022-0261
Azer, Z., Leone, M., Chatelon, J., Abulfatth, A., Ahmed, A., Saleh, R. Study of initial blood lactate and delta lactate as early predictor of morbidity and mortality in trauma patients. EKB Journal Management System, 2023; 39(1): 149-156. doi: TEJA-2022-0261

Study of initial blood lactate and delta lactate as early predictor of morbidity and mortality in trauma patients

Egyptian Journal of Anaesthesia
Volume 39, Issue 1, December 2023, Page 149-156  XML PDF (277.87 K)
DOI: TEJA-2022-0261
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Authors
Zarif Azer; Marc Leone; Jeanne Chatelon; Amr Abulfatth; Ahmed Ahmed; Rabab Saleh
Abstract
Background
It has been demonstrated that lactate is a predictive indicator in trauma. It is yet unclear how non-normalization of lactate affects trauma victims.
Methods
In trauma patients, blood lactate levels were measured at admission and every 2 hours after that. A multivariate logistic regression analysis was conducted to identify the crucial variables to evaluate hospital mortality risk factors.
Results
519 patients with trauma were assessed. Male patients (79%, n = 409) who were mostly young (42±20 years old) and had no comorbidities (ASA 1) made up the majority of the patient population. Patients who had normalization of serum lactate in the first 24 hours represented 76% (n = 392) of all trauma patients. Male patient status (OR = 2.2 (1.1–4.6)) and blood alcohol level (OR = 0.64 (0.44–0.91)) were independently linked in a logistic regression model with the failure of serum lactate to normalize in trauma patients over the initial 24 hours. Three variables were independently associated with hospital mortality: a GCS >9 (OR = 0.78(0.61–0.96)), and a pH> 7.37 (OR = 0.0028(0.00066–0.52)) at admission were protecting factors. One of the main risks for death in the pre-field was cardiorespiratory arrest (OR = 62 (2.2–4400)). Hospital mortality was not related to non-normalization of serum lactate in the initial 24 hours (OR = 1.8(0.4–7.9)).
Conclusions
Although serum lactate at admission is associated to trauma patient prognosis, our study failed to show that non-normalization of serum lactate in the initial 24 hours was a factor that could predict hospital mortality. A future study focusing on normalizing serum lactate in a shorter scale of time could be interesting.
Keywords
Lactates; patient prognosis; Trauma
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