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.