Lactate and base deficit combination score for predicting blood transfusion need in blunt multi-trauma patients.

Özakın E., Özcan Yazlamaz N., Baloğlu Kaya F., Çanakçı M. E., Bilgin M.

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, cilt.28, sa.5, ss.599-606, 2022 (SCI-Expanded) identifier identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 28 Sayı: 5
  • Basım Tarihi: 2022
  • Doi Numarası: 10.14744/tjtes.2021.02404
  • Dergi Adı: Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.599-606
  • Anahtar Kelimeler: Base deficit, blood transfusion need, combined, formula, lactate, trauma, SHOCK INDEX, SERUM LACTATE, PROGNOSTIC-SIGNIFICANCE, MASSIVE TRANSFUSION, CRITICAL ILLNESS, MORTALITY, ARTERIAL, CLEARANCE, UTILITY, EXCESS
  • Eskişehir Osmangazi Üniversitesi Adresli: Evet

Özet

Abstract
Background:
Lactate and base deficit (BD) values are parameters evaluated as indicators of tissue perfusion and have been used as markers of severity of injury and mortality.
Objectives
The aim of the study was to determine the relationship between combined score and blood transfusion need within 24 hours and comparison of the variables between transfusion and non-transfusion group, correlation lactate with BD and with physiological, laboratory parameters, and determining the major risk factors of patients for the need for blood transfusion,
Methods:
The study included a total of 359 patients(245 males, median age: 40,min-max: 18-95) with blunt multi-trauma. Demographics data, laboratory parameters (hemoglobin, hematocrit, lactate, BD, pH), physiologic parameters(SBP,DBP,HR,RR), shock index(SI) and Revised trauma score(RTS) were recorded. Logistic regression method was used to create the combined score (CS) formula using lactate and BD values. According to this formula, the probability value of 0.092447509 was calculated for the need for blood transfusion within 24 hours. If CS was higher than the probability value, the need for blood transfusion within 24 hours was considered. Also, univariate analysis was used to determine major risk for blood transfusion need in 24 hours, and the receiver operating characteristic curves were performed to compare CS, lactate, BD, SI and RTS.
Results:
The comparison between transfusion and non-transfusion group there was significance between SBP,DBP,HR,RR,SpO2,GCS, hemoglobin, hematocrite, lactate, BD, pH, SI and RTS(for each p<0.05). Lactate value has a positive correlation with SI, HR and has a negative correlation with BD, RTS, SBP, DBP. BD values has a positive correlation with RTS, SBP, DBP, Hb, and Htc; and has a negative correlation with SI,HR and RR. The main risks for blood transfusion need were SI, lactate, BD, SBP and spO2%. CS was >0.09 in 100(27.85%) patients and 41 with high CS had blood transfusion within 24 hours (p<0.001;OR21.803,sensitivity 83.7%,specificity 81%,positive predictive value 41%, negative predictive value 96.9%). A ROC curve showed that CS(AUC: 86.) was more significant than SI and RTS for the need for blood transfusion.
Conclusion:
CS is effective for predicting blood necessity in 24 hours for blunt multi-trauma patients.