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Admission base deficit is superior to lactate in identifying shock and resuscitative needs in trauma patients. | LitMetric

Admission base deficit is superior to lactate in identifying shock and resuscitative needs in trauma patients.

Am J Surg

UCSF Fresno Department of Surgery, Department of Surgery, 1st Floor, 2823 Fresno St, Fresno, CA, 93721, USA. Electronic address:

Published: December 2020

AI Article Synopsis

Article Abstract

Background: Base Deficit (BD) and lactate have been used as indicators of shock and resuscitation. This study was done to evaluate the utility of BD and lactate in identifying shock and resuscitative needs in trauma patients.

Methods: A prospective observational study was performed from 3/2014-12/2018. Data included demographics, admission systolic BP, ISS, BD, lactate, blood transfusion, and outcomes. BD and lactate were modeled continuously and categorically and compared.

Results: 2271 patients were included. BD and lactate were moderately correlated (r = 0.63 p < 0.001). On univariate regression, BD and lactate were associated with transfusion requirement and mortality (p < 0.001), but on multivariate regression, only BD was associated with transfusion requirement and mortality (OR = 1.2, p < 0.001; OR = 1.1, p < 0.001, respectively). BD discriminated better than lactate for hypotension, higher ISS, increased transfusion requirements and mortality.

Conclusions: Admission BD and lactate levels are correlated following injury, but BD is superior to lactate in identifying shock, resuscitative needs and mortality in severely injured trauma patients.

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Source
http://dx.doi.org/10.1016/j.amjsurg.2020.10.005DOI Listing

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