Lactate in trauma: a poor predictor of mortality in the setting of alcohol ingestion

Hadley K Herbert, Tracey A Dechert, Luke Wolfe, Michel B Aboutanos, Ajai K Malhotra, Rao R Ivatury, Therese M Duane
American Surgeon 2011, 77 (12): 1576-9
Resuscitation end point markers such as lactate and base deficit (BD) are used in trauma to identify and treat a state of compensated shock. Lactate and BD levels are also elevated by alcohol. In blunt trauma patients with positive blood alcohol levels, lactate may be a poor indicator of injury. Retrospective data were collected on 1083 blunt trauma patients with positive blood alcohol levels admitted a Level I trauma center between 2003 and 2006. Patients were stratified by Injury Severity Score, age, gender, and Glasgow Coma Score. Logistic regression analyses were used to assess lactate and BD as independent risk factors for mortality. Seventy-four per cent of patients had an abnormal lactate level compared with 28 per cent with abnormal BD levels. In patients with mild injury, lactate levels were abnormal in more than 70 per cent of patients compared with less than 20 per cent of patients with abnormal BD levels. Linear regression showed lactate is not a significant predictor of mortality. Regardless of Injury Severity Score, lactate appeared to be more often abnormal than BD in the setting of alcohol ingestion. Additionally, because BD, and not lactate, was shown to be an independent predictor of mortality, lactate may not be a reliable marker of end point resuscitation in this patient population.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"