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Base excess as a predictor for injury severity in pediatric trauma patients
Yochai Levi1, Igor Jeroukhimov, Kobi Peleg
1Pediatric Emergency Unit, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel.
Insights
Admission base excess shows a weak correlation with outcomes in pediatric trauma patients, suggesting it is not a reliable prognostic factor in this age group. Further research is needed to understand its role in predicting severity and length of stay.
Area of Science:
- Pediatric Trauma Care
- Biochemical Markers in Critical Care
- Injury Severity Assessment
Background:
- Base excess (BE) is a recognized predictor of mortality and injury severity in adult trauma patients.
- Limited research exists on the prognostic value of BE specifically in pediatric trauma populations.
- Understanding BE's role in children is crucial for accurate clinical assessment.
Purpose of the Study:
- To evaluate the predictive value of admission base excess in pediatric trauma patients.
- To assess the correlation of base excess with intensive care unit (ICU) admission rates.
- To determine the relationship between base excess and length of hospital stay in children.
Main Methods:
- Retrospective analysis of pediatric trauma patients (0-16 years) at a Level II trauma center (2006-2009).
- Inclusion criteria: trauma team activation.
- Data collected: admission base excess, injury details, Injury Severity Score (ISS), hospital length of stay, and ICU admission.
Main Results:
- A weak linear correlation was observed between admission base excess and ICU admission/hospital length of stay.
- Base excess showed a stronger correlation in the youngest (0-6 years) but not in the middle age group.
- A weak positive correlation (R Spearman = 0.26) existed with ISS, yet 40% of severely injured children (ISS >25) had normal base excess.
Conclusions:
- Admission base excess appears to be a weak prognostic indicator in pediatric trauma patients at this facility.
- Its utility in predicting ICU admission or length of stay is limited.
- Further investigation is warranted to clarify the role of base excess in pediatric trauma outcomes.
Background:
Base excess is considered a predictor of mortality and severity of injury in trauma patients. Base excess had been widely examined in different settings. Only few studies have examined the role of base excess in pediatric trauma patients.
Objective:
To evaluate the value of admission base excess in pediatric trauma patients with respect to intensive care unit (ICU) admission rate and length of hospital stay.
Methods:
A retrospective study of pediatric trauma patients was conducted at a Level II trauma center. All patients aged 0-16 years for which a trauma team was activated over the years 2006-2009 were included. Study database included admission base excess, mechanism of injury, location and nature of injury, injury severity score, length of hospital stay, and ICU admission.
Results:
The study group consisted of 359 patients. There was a weak linear correlation between admission base excess, length of stay in the hospital, and ICU admission. Base excess seemed to show a stronger correlation for the youngest age group (0-6 years) and no correlation for the middle age group. There was a positive but weak correlation (R Spearman = 0.26) between admission base excess and Injury Severity Score (ISS). However, 40% of the children with an ISS score >25 had normal admission base excess values. The area under the curve of the receiver operating characteristic curves of base excess for predicting ICU admission was 0.66.
Conclusions:
The admission base excess in pediatric trauma patients seems to be a weak prognostic factor in our facility.
