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The association between the initial lactate level and need for massive transfusion in severe trauma patients with and without traumatic brain injury
BACKGROUND: Exsanguination is a major cause of death in severe trauma patients. The purpose of this study was to analyze the prognostic impact of the initial lactate level for massive transfusion (MT) in severe trauma. We divided patients according to subgroups of traumatic brain injury (TBI) and no...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Society of Critical Care Medicine
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6895468/ https://www.ncbi.nlm.nih.gov/pubmed/31795623 http://dx.doi.org/10.4266/acc.2019.00640 |
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author | Park, Young Hoon Ryu, Dong Hyun Lee, Byung Kook Lee, Dong Hun |
author_facet | Park, Young Hoon Ryu, Dong Hyun Lee, Byung Kook Lee, Dong Hun |
author_sort | Park, Young Hoon |
collection | PubMed |
description | BACKGROUND: Exsanguination is a major cause of death in severe trauma patients. The purpose of this study was to analyze the prognostic impact of the initial lactate level for massive transfusion (MT) in severe trauma. We divided patients according to subgroups of traumatic brain injury (TBI) and non-TBI. METHODS: This single-institution retrospective study was conducted on patients who were admitted to hospital for severe trauma between January 2016 and December 2017. TBI was defined by a head Abbreviated Injury Scale ≥3. Receiver operating characteristic analysis was used to analyze the prognostic impact of the lactate level. Multivariate analyses were performed to evaluate the relationship between the MT and lactate level. The primary outcome was MT. RESULTS: Of the 553 patients, MT was performed in 62 patients (11.2%). The area under the curve (AUC) for the lactate level for predicting MT was 0.779 (95% confidence interval [CI], 0.742 to 0.813). The AUCs for lactate level in the TBI and non-TBI patients were 0.690 (95% CI, 0.627 to 0.747) and 0.842 (95% CI, 0.796 to 0.881), respectively. In multivariate analyses, the lactate level was independently associated with the MT (odds ratio [OR], 1.179; 95% CI, 1.070 to 1.299). The lactate level was independently associated with MT in non-TBI patients (OR, 1.469; 95% CI, 1.262 to 1.710), but not in TBI patients. CONCLUSIONS: The initial lactate level may be a possible prognostic factor for MT in severe trauma. In TBI patients, however, the initial lactate level was not suitable for predicting MT. |
format | Online Article Text |
id | pubmed-6895468 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Korean Society of Critical Care Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-68954682019-12-30 The association between the initial lactate level and need for massive transfusion in severe trauma patients with and without traumatic brain injury Park, Young Hoon Ryu, Dong Hyun Lee, Byung Kook Lee, Dong Hun Acute Crit Care Original Article BACKGROUND: Exsanguination is a major cause of death in severe trauma patients. The purpose of this study was to analyze the prognostic impact of the initial lactate level for massive transfusion (MT) in severe trauma. We divided patients according to subgroups of traumatic brain injury (TBI) and non-TBI. METHODS: This single-institution retrospective study was conducted on patients who were admitted to hospital for severe trauma between January 2016 and December 2017. TBI was defined by a head Abbreviated Injury Scale ≥3. Receiver operating characteristic analysis was used to analyze the prognostic impact of the lactate level. Multivariate analyses were performed to evaluate the relationship between the MT and lactate level. The primary outcome was MT. RESULTS: Of the 553 patients, MT was performed in 62 patients (11.2%). The area under the curve (AUC) for the lactate level for predicting MT was 0.779 (95% confidence interval [CI], 0.742 to 0.813). The AUCs for lactate level in the TBI and non-TBI patients were 0.690 (95% CI, 0.627 to 0.747) and 0.842 (95% CI, 0.796 to 0.881), respectively. In multivariate analyses, the lactate level was independently associated with the MT (odds ratio [OR], 1.179; 95% CI, 1.070 to 1.299). The lactate level was independently associated with MT in non-TBI patients (OR, 1.469; 95% CI, 1.262 to 1.710), but not in TBI patients. CONCLUSIONS: The initial lactate level may be a possible prognostic factor for MT in severe trauma. In TBI patients, however, the initial lactate level was not suitable for predicting MT. Korean Society of Critical Care Medicine 2019-11 2019-11-29 /pmc/articles/PMC6895468/ /pubmed/31795623 http://dx.doi.org/10.4266/acc.2019.00640 Text en Copyright © 2019 The Korean Society of Critical Care Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Park, Young Hoon Ryu, Dong Hyun Lee, Byung Kook Lee, Dong Hun The association between the initial lactate level and need for massive transfusion in severe trauma patients with and without traumatic brain injury |
title | The association between the initial lactate level and need for massive transfusion in severe trauma patients with and without traumatic brain injury |
title_full | The association between the initial lactate level and need for massive transfusion in severe trauma patients with and without traumatic brain injury |
title_fullStr | The association between the initial lactate level and need for massive transfusion in severe trauma patients with and without traumatic brain injury |
title_full_unstemmed | The association between the initial lactate level and need for massive transfusion in severe trauma patients with and without traumatic brain injury |
title_short | The association between the initial lactate level and need for massive transfusion in severe trauma patients with and without traumatic brain injury |
title_sort | association between the initial lactate level and need for massive transfusion in severe trauma patients with and without traumatic brain injury |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6895468/ https://www.ncbi.nlm.nih.gov/pubmed/31795623 http://dx.doi.org/10.4266/acc.2019.00640 |
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