Base Deficit, Lactate and Shock Index as Mortality Predictors in Trauma Patients

Abstract

Introduction: Physiological responses to hemorrhage, such as hypotension and tachycardia, are not always proportional to the state of shock, which has led to the need to use other predictors.

Objective: To analyze the characteristics of base deficit, lactate and severe shock index as predictors of mortality in multiply injured patients.

Methods: An analytical, observational and retrospective study was carried out in the anesthesiology and resuscitation service of General Calixto García University Hospital, between August 2018 and August 2020. The sample was made up of 50 patients, according to nonprobabilistic selection criteria of the researcher.

Results: Patients who suffered cranial trauma were seven times more likely to die. The index of severe shock at three hours tripled the risk of death. Lactate and baseline deficit correlated significantly with shock index greater than one. Blood transfusion doubled the risk of death, while amine requirements were not shown to be poor prognostic factors. Among complications, systemic inflammatory response was shown to have nine times higher risk of dying and multiple organ dysfunction seven times, but the presence of pneumonia did not influence death.

Conclusions: The severe shock index was considered a prognostic factor for mortality in polytraumatized patients, as far as it tripled the risk of dying and was related to elevated lactate and altered base deficit values.