Characterization of Acidosis in Trauma Patient.

Area of Science:

• Trauma critical care
• Acid-base balance in critical illness
• Injury pathophysiology

Background:

• Acidosis is not a reliable sole predictor of mortality in trauma patients.
• Limited data exist on factors influencing survival among trauma patients with acidosis.

Purpose of the Study:

• To characterize outcomes of trauma patients presenting with acidosis.
• To identify modifiable risk factors associated with mortality in this patient group.

Main Methods:

• Retrospective observational study of 532 trauma patients (November 2013 - May 2017).
• Data from UAMS trauma registry; primary outcome: hospital mortality.
• Statistical analyses included t-tests, Chi-squared, and logistic regression for odds ratios.

Main Results:

• 64.7% of patients presented with acidosis (pH < 7.35).
• Nonsurvivors were older, more acidotic (pH ≤ 7.2), with lower GCS, SBP, and higher INR and ISS.
• Adjusted analysis showed pH ≤ 7.0, pH 7.0-7.2, INR > 1.6, GCS ≤ 8, and ISS > 15 were associated with increased mortality.

Conclusions:

• pH ≤ 7.2 is linked to increased mortality in trauma patients.
• For patients with pH ≤ 7.2, coagulopathy (elevated INR) is the primary mortality predictor.
• A treatment goal of pH > 7.2 may be appropriate; targeting coagulopathy is crucial.