중증 외상환자에서 염기 결핍수치의 유용성

초록

BACKGROUND: This study's objective was to determine the prognostic value of the base deficit measured in the emergency department(ED) and to determine whether base deficit can provide information not provided by advanced injury scoring system. METHODS: This study was a retrospective analysis of data collected for two years. Thirty-two severe trauma patients who were admitted to the Emergency Department of Korea University Hospital were included in this study. The patients were divided into two groups: the normal base deficit group(-3 mmol/L to 3 mmol/L) and the elevated base deficit group(>3 mmol/L). The base-deficit value, age, sex, head injury, organ failure rate, and survival were considered, and the also Revised Trauma Score(RTS), Acute Physiology And Chronic Health Evaluation(APACHE II), and Injury Severity Score(ISS) were measured. RESULT: The elevated base-deficit group showed a lower survival rate and a higher organ failure rate compared to the normal base deficit group. Logistic Regression showed a strong association between base deficit and mortality rate. Among the previous injury scoring Systems(RTS, APACHE II, ISS), base deficit had the strongest correlation with RTS. By using base deficit value and the RTS together, we obtained a higher positive predictive value than that obtained by using base deficit or RTS alone. CONCLUSION: The admission value of the base deficit in the ED is a useful tool in predicting the outcome in severe trauma patients, and it can be an adjunct to previous injury scoring systems. As an advanced injury scoring System is developed in the future, the base deficit may have some significant role.

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