The effect of ethanol on lactate and base deficit as predictors of morbidity and mortality in trauma

The American Journal of Emergency Medicine
Mark L GustafsonAudis Bethea

Abstract

The objective of this study was to assess the predictive value of lactate and base deficit in determining outcomes in trauma patients who are positive for ethanol. Retrospective cohort study of patients admitted to a level 1 trauma center between 2005 and 2014. Adult patients who had a serum ethanol, lactate, base deficit, and negative urine drug screen obtained upon presentation were included. Data for 2482 patients were analyzed with 1127 having an elevated lactate and 1092 an elevated base deficit. In these subgroups, patients with a positive serum ethanol had significantly lower 72-hour mortality, overall mortality, and hospital length of stay compared with the negative ethanol group. Abnormal lactate (odds ratio [OR], 2.607; 95% confidence interval [CI], 1.629-4.173; P = .000) and base deficit (OR, 1.917; 95% CI, 1.183-3.105; P = .008) were determined to be the strongest predictors of mortality in the ethanol-negative patients. Injury Severity Score was found to be the lone predictor of mortality in patients positive for ethanol (OR, 1.104; 95% CI, 1.070-1.138; P = .000). Area under the curve and Youden index analyses supported a relationship between abnormal lactate, base deficit, and mortality in ethanol-positive patient...Continue Reading

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Citations

Feb 10, 2016·The American Journal of Emergency Medicine·I IbrahimM Hartman
Apr 14, 2016·Critical Care : the Official Journal of the Critical Care Forum·Rolf RossaintDonat R Spahn
Aug 5, 2016·Annals of Medicine and Surgery·Jacob CalvertRitankar Das
Feb 7, 2018·Der Anaesthesist·H LierB Hossfeld
Sep 27, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Nils WagnerUNKNOWN TraumaRegister DGU3
Mar 29, 2019·Critical Care : the Official Journal of the Critical Care Forum·Donat R SpahnRolf Rossaint
Jul 10, 2019·Journal of Trauma Nursing : the Official Journal of the Society of Trauma Nurses·Lisa B ElginSarah Dunlap
Sep 21, 2016·The Journal of Trauma and Acute Care Surgery·Christopher T LewisMark J Midwinter
Jul 20, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Yuru BoonMui Teng Chua
Aug 29, 2020·The American Journal of Nursing·Nicole W CaldwellChristopher A VanFosson
Oct 8, 2020·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Nadim MahmudMarina Serper
Mar 16, 2021·Journal of the American College of Emergency Physicians Open·Arvin Radfar AkhavanDaniel J Henning
Jun 8, 2021·Journal of the American College of Emergency Physicians Open·Luke Wood, Matthew C DeLaney
Jul 2, 2021·International Journal of General Medicine·Yu ChenWenliang Tan
Mar 24, 2021·Shock·Maximilian LeibleinNils Wagner
Sep 6, 2021·European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes·Péter JávorPetra Hartmann

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