Document Type : original article

Authors

1 MD, Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

2 MD, Emergency Research Team, Tabriz University of Medical Sciences, Tabriz, Iran.

3 MD, Emergency Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.

4 Student, Faculty of Veterinary Medicine, Islamic Azad University of Tabriz, Tabriz, Iran.

5 Assistant professor, MD-PhD of Medical Genetics, Road Traffic Injury Research Center, Statistics and Epidemiology Department, Tabriz University of Medical Sciences, Tabriz, Iran

Abstract

Background: Trauma is an important cause of disability and death in young people.  The aim was to evaluate associations serum lactate level and in-hospital mortality in multi-traumatic children.
 Methods: In this cross-secthional study, all children with multi-trauma  admitted to the emergency department in Shohada and Imam Reza hospitals of Tabriz/Iran were evaluated from 2018 to 2020. at the time of admission to the emergency department, serum lactate, PRISM score, and other findings as well as outcome were checked and the outcome for all patients. Patients classified to  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 used by SPSS.22. The P-value<0.05 and OR with 95% confidence interval were considered statistically significant.
Results: Out of 110 children admitted to hospital, 10 (9%) died in hospital. Mean lactate level  was 3.2 mmol/l and 85 patients (77.2%) had lactate level>2 mmol/l. 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 = 1.27; 95% CI, 1.19-1.35; P <0.001). Multiple regression study showed that a high lactate level (OR =1.17; 95% CI, 1.07-1.29; P=0.001), high PRISM score (OR = 1.15; 95% CI, 1.11-1.20; P<0.001) and low albumin level (OR =0.92; 95% CI, 0.88-0.96; P<0.001) were as independent risk factors for mortality.
Conclusions: High blood lactate level was an independent factor in increase mortality rate in multi-traumatic children in emergency department.

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