Serum lactate as a predictor of early outcomes among trauma patients in Uganda

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dc.contributor.authorOkello, Michael
dc.contributor.authorMakobore, Patson
dc.contributor.authorWangoda, Robert
dc.contributor.authorUpoki, Alex
dc.contributor.authorGalukande, Moses
dc.date.accessioned2021-12-14T11:41:34Z
dc.date.available2021-12-14T11:41:34Z
dc.date.issued2014
dc.description.abstractTrauma is the leading cause of death in the developed world. Accurate assessment of severity of injuries is critical in informing treatment choices. Current models of assessing severity of injury are not without limitations. The objective of this study therefore was to determine the diagnostic accuracy of serum lactate assays in assessing injury severity and prediction of early outcomes among trauma patients. Methods: This was a cross-sectional analytical study. Consecutive series of all eligible patients had a single venous blood sample drawn for lactate assay analysis (index test) and a concurrent Kampala Trauma Score (KTS) II value determination (reference test). Admitted patients were followed up to assess early outcomes (length of hospital stay and mortality). Results: Out of the 502 trauma patients recruited, 108 (22%) were severely injured, 394 (78%) had non-severe injuries, and 183 were admitted. There was a significant difference between median (interquartile range (IQR)) lactate levels among the severely injured (4.3 (2.6, 6.6)) and the non-severely injured (2.4 (1.6, 3.5), p < 0.001). After a 72-h follow-up of the admitted patients, 102 (56%) were discharged, 61 (33%) remained in the hospital, 3 (2%) remained in the ICU, and 17 (3%) had died. The area under the receiver operator characteristic (ROC) curve was 0.75 for injury severity. Serum lactate ≥2.0 mmol/l had a hazard ratio of 1.10 (p < 0.001) for emergency department disposition, 4.33 (p = 0.06) for the 72-h non-discharge disposition, and 1.19 (p < 0.001) for 72-h mortality. Serum lactate ≥2.0 mmol/l at admission was useful in discriminating severe from non-severe injuries with a sensitivity of 88%, specificity of 38%, PPV of 30%, and NPV of 92%.en_US
dc.identifier.citationOkello, M., Makobore, P., Wangoda, R., Upoki, A., & Galukande, M. (2014). Serum lactate as a predictor of early outcomes among trauma patients in Uganda. International journal of emergency medicine, 7(1), 1-9.en_US
dc.identifier.urihttps://intjem.biomedcentral.com/articles/10.1186/s12245-014-0020-9
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/490
dc.language.isoenen_US
dc.publisherInternational journal of emergency medicineen_US
dc.subjectSerum lactateen_US
dc.subjectInjury severityen_US
dc.subjectTraumaen_US
dc.subjectOutcomeen_US
dc.titleSerum lactate as a predictor of early outcomes among trauma patients in Ugandaen_US
dc.typeArticleen_US
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