The Association between Serum Lactate Level and Hospital Outcome in Children with Multi-Trauma

Background: Trauma is an important cause of disability and death in young people.  This study aimed to investigate the association between serum lactate level and in-hospital mortality in multi-traumatic children. Method: In this cross-sectional study, all children with multi-trauma admitted to the emergency department in Shohada and Imam Reza hospitals of Tabriz/Iran were evaluated from ۲۰۱۸ to ۲۰۲۰. At the time of admission to the emergency department, serum lactate, PRISM (Pediatric risk of mortality) score, and other findings as well as outcome were checked and correlated with the outcomes for all patients. Patients were classified into two groups (based on outcome) and six groups (based on lactate levels) to evaluate associations between results. The Chi-square test, independent samples t-test, ANOVA, and multivariate logistic regression test were performed in SPSS.۲۲. P-value<۰.۰۵ and OR with ۹۵% confidence interval were considered statistically significant. Result: Out of ۱۱۰ admitted children, ۱۰ (۹%) died in hospital. Mean lactate level was ۳.۲ mmol/l and ۸۵ patients (۷۷.۲%) had lactate level>۲ mmol/l (millimoles). The initial blood lactate level was directly correlated with mortality.  This relationship was confirmed even after adjusting for variables such as the PRISM score (OR = ۱.۲۷; ۹۵% CI, ۱.۱۹-۱.۳۵; P <۰.۰۰۱). Multiple regression study showed that a high lactate level (OR =۱.۱۷; ۹۵% CI, ۱.۰۷-۱.۲۹; P=۰.۰۰۱), high PRISM score (OR = ۱.۱۵; ۹۵% CI, ۱.۱۱-۱.۲۰; P<۰.۰۰۱), and low albumin level (OR =۰.۹۲; ۹۵% CI, ۰.۸۸-۰.۹۶; P<۰.۰۰۱) were independent risk factors for mortality. Conclusion: High blood lactate level was an independent factor in the increase of mortality rate in the emergency department.

Keywords:

Trauma , Children , Association , Lactate , Hospital mortality