Initial base deficit as predictors for mortality and transfusion requirement in the severe pediatric trauma except brain injury.
OBJECTIVE
The initial base deficit (BD) is an important indicator of shock in adult trauma patients, but its value is unclear in pediatric trauma patients. This study assessed the ability of the initial BD to predict mortality and blood transfusion requirements in children except severe brain injury patients.


METHODS
This study was a retrospective review of pediatric patients with severe trauma arriving at the emergency department of a university hospital from January 1998 to June 2005. Blood pressure, the initial BD, and the Injury Severity Score were assessed as independent predictors of mortality and the blood transfusion requirement using multiple regression analysis.


RESULTS
The study group constituted 102 patients. According to the multiple regression analysis results, the initial systolic blood pressure, Injury Severity Score, and blood transfusion requirement were not independent predictors of mortality (P = 0.104, 0.959, 0.386, respectively). By contrast, the initial BD was an independent predictor, with an odds ratio of 13.6 for BD of -8 mEq/L or less (confidence interval [CI], 3.51-35.23, P = 0.037), and systolic blood pressure and BD were independent predictors of blood transfusion requirement; the odds ratio for hypotension was 3.2 (CI, 0.51-8.32, P = 0.044), and the odds ratio was 15.3 for BD values of -8 or less (CI, 2.24-51.43, P = 0.003).


CONCLUSIONS
The initial BD in pediatric trauma patients except severe brain injury was an independent predictor of mortality and blood transfusion requirement within 24 hours. Mortality and blood transfusion requirement were significantly high when initial BD was less than -8 mEq/L.
Jung
Jinhee
J
Department of Emergency Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
Eo
Eunkyung
E
Ahn
Kiok
K
Noh
Hyun
H
Cheon
Youngjin
Y
D000137:Acid-Base Imbalance / Q000097:blood / Q000401:mortality* / Q000628:therapy; D001794:Blood Pressure / Q000502:physiology*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D001930:Brain Injuries / Q000097:blood / Q000401:mortality* / Q000628:therapy; D002648:Child; D016001:Confidence Intervals; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D012044:Regression Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy