Predicting severity of trauma by admission white blood cell count, serum potassium level, and arterial pH

Traumatized patients frequently have leukocytosis, hypokalemia, and acidosis. The purpose of this study was to determine whether the admission serum potassium level (K+), white blood cell count (WBC), and arterial pH predicted the severity of injury in trauma patients. The injury severity score (ISS), total length of stay in the hospital (tLOS), and length of stay in the intensive care unit (LOS-ICU) were used to measure the severity of the injury. The charts of 156 consecutive trauma patients admitted to a level II trauma center were reviewed. Acidosis (arterial pH < 7.35) was associated with an increased mean ISS, tLOS, and LOS-ICU. Leukocytosis (WBC > or = 10,500/mm3) correlated with a higher mean ISS, and LOS-ICU. Patients with hypokalemia (K+ < 3.6 mEq/L) had an increased mean ISS and tLOS. Our findings suggest that the admission white blood cell count, serum potassium level, and arterial pH have a predictive value as to the severity of injury.