TY - JOUR PY - 2009// TI - Admission base deficit as a long-term prognostic factor in severe pediatric trauma patients JO - Journal of trauma A1 - Hindy-François, Clémence A1 - Meyer, Philippe A1 - Blanot, Stephane A1 - Marqué, Sophie A1 - Sabourdin, Nada A1 - Carli, Pierre A1 - Orliaguet, Gilles SP - 1272 EP - 1277 VL - 67 IS - 6 N2 - BACKGROUND: Base deficit (BD) is a prognostic tool that correlates with trauma scores and mortality in adult trauma patients. Retrospective studies have shown that admission BD more than 8 mmol/L is associated with an increased risk of mortality. This is the first prospective European study aimed at evaluating the prognostic value of admission BD in traumatized children. METHODS: One hundred severely traumatized children were included if an arterial BD had been calculated on arrival in the trauma room of a university hospital. Epidemiologic, medical, and biological data (including admission BD and lactates concentration) were recorded and compared using a univariate analysis. The primary endpoint was in-hospital mortality. Secondary endpoints were outcome on discharge and at 6 months. Cutoff values for BD or lactates regarding outcomes were determined using receiver operating characteristic curves if these data had been isolated on multivariate analysis (p < 0.05). RESULTS: Sixty-eight boys and 32 girls, aged 6.7 years, were enrolled from March 2003 to December 2005, mainly after road traffic accidents. Twenty-two died at the hospital, 34 children and 51 children were classified as having a good outcome on hospital discharge and 6 months later, respectively. After the multivariate procedure and receiver operating characteristic curve analysis, admission lactates more than 2.94 mmol/L and admission BD more than 5 mEq/L were independent risk factors for mortality (odds ratio 2.4 [95% confidence interval 1.3-4.6]) and poor outcome at 6 months (odds ratio 2.5 [95% confidence interval 1.13-5.5]), respectively. DISCUSSION: BD could be used to predict the long-term morbidity and may not be related to morbidity and mortality at discharge.

Language: en

LA - en SN - 0022-5282 UR - http://dx.doi.org/10.1097/TA.0b013e31819db828 ID - ref1 ER -