Base excess determined within one hour of admission predicts mortality in patients with severe pelvic fractures and severe hemorrhagic shock

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
Rahel AbtM Keel

Abstract

Unstable pelvic ring fractures with exsanguinating hemorrhages are rare but potentially lifethreatening injuries. The aim of this retrospective study was to evaluate whether early changes in acid- base parameters predict mortality of patients with severe pelvic trauma and hemorrhagic shock. Data for 50 patients with pelvic ring disruption and severe hemorrhage were analyzed retrospectively. In all patients, the pelvic ring was temporarily stabilized by C-clamp. Patients with ongoing bleeding underwent laparotomy with extra and/or intraperitoneal pelvic packing, as required. Base excess, lactate, and pH were measured upon admission and at 1, 2, 3, 4, 6, 8, and 12 h postadmission. Patients were categorized as early survivors (surviving the first 12 h after admission) and nonsurvivors. Statistical analysis was performed by Mann-Whitney test; significance was assumed at p < 0.05. Receiver operating characteristic curves were generated for early mortality from each acid-base variable. Sixteen patients (32%) were nonsurvivors due to hemorrhagic shock (n = 13) or severe traumatic brain injury (n = 3). Thirty-four patients were early survivors. Base excess, lactate, and pH significantly discriminated between early survivors and nonsurv...Continue Reading

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Citations

Oct 1, 2009·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Otmar Trentz, Ingo Marzi
Feb 10, 2016·The American Journal of Emergency Medicine·I IbrahimM Hartman
Apr 17, 2014·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·I Marzi, T Lustenberger
Sep 27, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Nils WagnerUNKNOWN TraumaRegister DGU3
Nov 16, 2017·The Journal of Trauma and Acute Care Surgery·Shunsuke YoshikawaYasuhiro Otomo
Aug 25, 2020·Therapeutic Hypothermia and Temperature Management·Jianru ShiRobert A Kloner
Mar 24, 2021·Shock·Maximilian LeibleinNils Wagner

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