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Journal of the Korean Society of Traumatology 2005;18(2):127-134.
The Comparison of Base Deficit, Lactate, and Strong Ion Gap as Early Predictor of Mortality in Trauma Patients
Kyung Hye Park, M.D., Kang Hyun Lee, M.D., Seon Hyu Kim, M.D., Sung Bum Oh, M.D., Joong Bum Moon, M.D., Hyun Kim, M.D., Sung Oh Hwang, M.D., Heon Ju Kim, M.D.*
Department of Emergency Medicine and Neurosurgery* Wonju College of Medicine, Yonsei University, Wonju, Korea
외상환자의 초기 사망 예측 지표로서의 내원 초기의 염기 결핍, 젖산 및 강이온 차이의 유용성 비교
박경혜·이강현·김선휴·오성범·문중범·김 현·황성오·김헌주*
연세대학교 원주의과대학 응급의학과, 신경외과*
Abstract
Purpose
Currently, there is a variety of systems available for predicting prognosis of trauma patients such as trauma score, Injury severity score (ISS) and acid-base variables. But it is not clear that the initial acid-base variables are predictors of prognosis in trauma patients at the emergency department. The objective of this study is to compare the base deficit, lactate and strong ion gap as an early predictor of mortality in trauma patients. Methods: Retrospective record review of 136 trauma patients needed to admit to intensive care unit via emergency department (June 2004 to February 2005). Data included age, injury mechanism, ISS, Revised trauma score (RTS), Multiple organ dysfunction score (MODS), Acute physiology and chronic health evaluation III (APACHE III), Glasgow coma scale (GCS), laboratory profiles, calculated anion gap and strong ion gap. Patients were divided into survivors and non-survivors, shock group and non-shock group with comparison by t-test;significance was assumed for p<0.05. Correlation between acid-base variables and mean arterial blood pressure (MABP) was evaluated. Results: There was a significant difference between the RTS (p=0.00), APACHE III (p=0.00), MODS (p=0.00), GCS (p=0.00) of survivors and non-survivors. There was no significant difference between the ISS (p=0.082), lactate (p=0.541), base excess (p=0.468) and SIG (p=0.894) of survivors and non-survivors. There was a significant difference between the RTS (p=0.023), APACHE III (p=0.002), lactate (p=0.000), base excess (p=0.000) and SIG (p=0.000) of shock and non-shock group. There was no significant difference between the ISS (p=0.270), MODS (p=0.442) and GCS (p=0.432) of shock and non-shock group. The base excess was most correlated to MABP (r2=0.150). Conclusion: Initial base deficit, serum lactate and SIG are not predictors of mortality in moderate to severe trauma patients. Initial base deficit, serum lactate and SIG are correlated with the mean arterial blood pressure in trauma patients in emergency department.
Key Words: Lactate; Base deficit; Strong ion gap; Trauma; Outcome


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