Roles of lactate and base deficit in predicting traumatic coagulopathy

Area of Science:

• Emergency Medicine
• Trauma Care
• Clinical Biochemistry

Background:

• Accurate initial assessment of trauma patients is critical for improving outcomes.
• Traumatic coagulopathy, in-hospital mortality, and massive transfusion are key concerns in trauma care.
• Lactate level and base deficit are commonly used biochemical markers in trauma assessment.

Purpose of the Study:

• To compare the predictive value of lactate level and base deficit for traumatic coagulopathy.
• To evaluate the association of lactate level and base deficit with in-hospital mortality and massive transfusion.
• To determine the independent risk factors for adverse outcomes in trauma patients.

Main Methods:

• Retrospective, observational, single-center study of 4,379 trauma patients (2016-2020).
• Logistic regression analysis to identify independent risk factors.
• Area Under the Receiver Operating Characteristic Curve (AUROC) analysis to assess predictive values.

Main Results:

• Base deficit was an independent predictor of traumatic coagulopathy (AUROC: 0.756).
• Lactate level was an independent predictor of in-hospital mortality (AUROC: 0.710).
• Lactate was not an independent predictor of coagulopathy, and base deficit was not an independent predictor of mortality.

Conclusions:

• Base deficit demonstrates superior predictive value for traumatic coagulopathy compared to lactate.
• Lactate level shows greater predictive power for in-hospital mortality than base deficit.
• Both lactate and base deficit are valuable markers requiring careful consideration in trauma patient management.