Lactate clearance versus revised trauma score as a prognostic value of polytrauma patients in emergency department

Abstract

Background Most deaths of trauma happened within first 48 h due to hemorrhage. Different trauma scores were proposed to assess the trauma severity that is crucial for promptly identifying and treating life-threatening traumatized cases. Blood lactate and lactate clearance (LC) can be indicative for mortality rates in traumatized cases. Aim This work was aimed to evaluate the LC ability to predict high mortality rates for polytrauma patients in the Emergency department versus the revised trauma score. Patient and methods This case-control study was conducted on 200 poly traumatic patients, they were subjected to measuring serum lactate during admission and then 6 h following admission. The revised trauma score (RTS) was documented once during admission. Results By dividing the patients into survived and died groups, the LC was significantly greater in survived group as opposed to died one. Revised traumas score 11 was significantly greater in died group as opposed to survived one. Surviving patients with RTS 11 were significantly lower than score 12. LC can significantly predict mortality (P=0.011 and area under the curve =0.733) at cut-off less than 0.3 with 88.89% sensitivity, 55.5% specificity, 8.6%. Whereas RTS can significantly predict mortality (P <0.001 and area under the curve=0.779) at cut-off less than or equal to 11 with 77.78% sensitivity, 78.01% specificity. Conclusions Although LC could be indicative of mortality rate prediction in polytrauma individuals admitted to the Emergency department, RTS often has better prediction results.