LAUSR

Trauma-related deaths are one of the top 10 causes of death. The diagnosis of occult hypoperfusion in patients who have suffered trauma is indeed challenging. The initial surge in lactate values is known to clear over time, and numerous studies have evaluated 6-h and 12-h lactate clearance. However, the trauma surgeon needs an objective indicator of his resuscitation efforts in record time. To find if blood lactate and a 2-h lactate clearance can predict mortality in trauma and to compare these with the available scores in trauma, namely, the revised trauma score (RTS), injury severity score (ISS) and the trauma-related injury severity score (TRISS). This was a prospective, descriptive study with a sample size of 200 patients. Patients with acute trauma presented to the emergency department between October 2016 and December 2018 who fit the inclusion criteria were chosen. Demographics were collected and the variables were compared. Out of the 200 patient studies, 15 expired during the 30-day period post-trauma. Admission serum lactate was found to be a good indicator for mortality (for values > 2.7 mmol/l) (sensitivity of 86.67 and specificity of 72.43). Independently, collected 2-h lactate predicts mortality (values > 2.5 mmol/L) (sensitivity of 60 and specificity of 87.57). Two-hour lactate clearance had no statistical significance in predicting mortality in trauma patients but maybe considered to be an important prognostic aid to predict adequacy of resuscitation efforts. Injury severity score was found to be a comparable triage scoring system. Lactate values at admission is a good indicator for mortality in trauma patients, as also independently measured lactate at 2 h; however, further studies may be required to prove benefit of lactate clearance in trauma patients. Injury severity score is comparable to lactate as a triage score.