Base deficit is superior to lactate in trauma.

Area of Science:

• Trauma resuscitation
• Critical care medicine
• Biochemical markers of shock

Background:

• Base deficit (BD) and lactate are established indicators for assessing shock and guiding resuscitation efforts.
• Understanding the relationship between BD and lactate is crucial for effective trauma patient management.

Purpose of the Study:

• To determine the association between Base Deficit (BD) and lactate levels in trauma patients.
• To compare the superiority of BD versus lactate in predicting outcomes such as transfusion needs and mortality.

Main Methods:

• Retrospective review of 1191 trauma patients from March 2014 to December 2016.
• Analysis of demographics, systolic blood pressure, Injury Severity Score (ISS), BD, lactate, blood transfusion data, and patient outcomes.
• BD and lactate were modeled both continuously and categorically for comparison.

Main Results:

• A strong correlation was found between BD and lactate (r = -0.76, p < 0.001).
• Elevated lactate and more negative BD were associated with increased transfusion requirements and mortality.
• Multivariate regression indicated BD, but not lactate, was independently associated with transfusion needs (OR = 0.8, p < 0.001).

Conclusions:

• Base deficit and lactate are significantly interrelated in trauma patients.
• Base deficit demonstrated superiority over lactate in assessing the requirement for blood transfusions.
• Categorical analysis of BD effectively discriminated high-risk trauma patients compared to lactate.