PREDICTIVE VALUE OF BASELINE ARTERIAL LACTATE LEVELS FOR MORTALITY AND MORBIDITY IN PEDIATRIC HEAD TRAUMA

Sabiha Sahin

Volume : VIII, Issue : II, February - 2019

PREDICTIVE VALUE OF BASELINE ARTERIAL LACTATE LEVELS FOR MORTALITY AND MORBIDITY IN PEDIATRIC HEAD TRAUMA

Sabiha Sahin

Abstract :

Head traumas include the majority of trauma patients in pediatric emergency cases. The approach and follow–up to the traumatised patient are often complicated. In the present study, we aimed to evaluate the correlation between the predictive value of baseline arterial lactate levels and clinical indicators including Glasgow Coma Scale scores and positive computed tomography results and determine the effect of lactate on morbidity and mortality.

Material and Methods: In this prospective study, a hundred children ageing from 1 to 17 years, taken to the Pediatric Emergency Department for isolated head trauma without any chronic disorder were included between 1 January 2011 and 31 December 2014. Also, 40 healthy controls matched with age and gender were enrolled to compare the arterial lactate levels.

Results: Arterial lactate levels were considerably higher in the patient group compared to the controls. More importantly, lactate levels were significantly higher in cases with positive computed tomography results (haematoma, fracture) than cases with negative computed tomography results (3.944�1.650 vs 1.578�0.842). Similarly, lactate levels were significantly higher in hospitalized patients due to neurological sequel compared to non–hospitalized patients (4.385�1.672 vs 1.750�0.880). Also, there was a significant difference in lactate levels between the exitus group and survivors (5.608�1.261 vs 2.359�1.502). A significant positive correlation was found between the baseline lactate levels and Glasgow Coma Scale scores.

Conclusion: Based on the results obtained in the present study, we concluded that early lactate measurement has a significant predictive value for mortality and morbidity in pediatric head traumas.