The impact of admission serum lactate on children with moderate to severe traumatic brain injury
Autoři:
Yue-qiang Fu aff001; Ke Bai aff001; Cheng-jun Liu aff001
Působiště autorů:
Department of Critical Care Medicine, Children’s Hospital, Chongqing Medical University, Chongqing, China
aff001; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
aff002; Chongqing Key Laboratory of Pediatrics, Chongqing, China
aff003
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0222591
Souhrn
Background
Lactate is used to evaluate the prognosis of adult patients with trauma. However, the prognostic significance of admission serum lactate in the setting of pediatric traumatic brain injury (TBI) is still unclear. We aim to investigate the impact of admission lactate on the outcome in children with moderate to severe TBI.
Methods
This retrospective study was conducted in a tertiary pediatric hospital between May 2012 and Jun 2018 included children with an admission Glasgow Coma Scale (GCS) of ≤13. Two hundred and thirteen patients were included in the analysis and 45 patients died in hospital.
Results
Admission lactate and glucose were significantly higher in non-survivors than those in survivors (P < 0.05). Admission lactate was positively correlated with admission glucose and negatively correlated with GCS in all patients (n = 213), subgroup of isolated TBI (n = 112) and subgroup of GCS ≤ 8 (n = 133), respectively. AUCs of lactate could significantly predict the mortality and were higher than those of glucose in all patients, subgroup of isolated TBI and subgroup of GCS ≤ 8, respectively. Multivariate logistic regression showed that admission lactate (Adjusted OR = 1.189; 95% CI: 1.002–1.410; P = 0.047) was independently associated with mortality, while admission glucose (Adjusted OR = 1.077; 95% CI: 0.978–1.186; P = 0.133) wasn’t an independent risk factor of death. Elevated admission lactate (> 2 mmol/L) was associated with death, reduced 14-day ventilation-free days, 14-day ICU-free days and 28-day hospital-free days.
Conclusions
Admission serum lactate can effectively predict the mortality of children with moderate to severe TBI. Elevated admission lactate is associated with death, reduced ventilator-free, ICU-free, and hospital-free days. Admission serum lactate could be used as a prognostic biomarker of mortality in children with moderate to severe TBI.
Klíčová slova:
Medicine and health sciences – Critical care and emergency medicine – Trauma medicine – Traumatic injury – Neurotrauma – Traumatic brain injury – Pediatrics – Neurology – Coma – Health care – Health care facilities – Hospitals – Intensive care units – Epidemiology – Medical risk factors – Physical sciences – Chemistry – Chemical compounds – Organic compounds – Carbohydrates – Monosaccharides – Glucose – Organic chemistry – Biology and life sciences – Biochemistry – Proteins – Hemoglobin – Population biology – Population metrics – Death rates
Zdroje
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Článek vyšel v časopise
PLOS One
2019 Číslo 9
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