Base excess, a useful marker in the prognosis of chest trauma in the geriatric population.
OBJECTIVE
To determine the usefulness of the determination of base excess in a cohort of elderly patients admitted to an intensive care unit (ICU) with a diagnosis of chest trauma.


METHODS
Two hundred and forty-nine patients were included aged 65 years and over with a diagnosis of thoracic trauma who required admission to the ICU. We made a statistical analysis in order to determine the association of the first base excess levels with mortality during the unit stay.


RESULTS
Two hundred and forty-nine patients, with a mean APACHE II score of 16.21±7.87 and 24.45±14.16 ISS. Mean ICU stay was 12.74±16.85 days and the mean hospital stay was 26.55±30.1 days. Statistical analysis showed an association with mortality in patients whose blood pressure was lower than 110mmHg on admission, with an OR=4.11 (95% CI 1.91 to 8.85) compared to patients with blood pressure between 110 and 140mmHg. Those patients who had base excess levels on admission of less than -6mmol/L also showed increased mortality compared to patients with higher levels, with an OR=3.12 (95% CI 1.51 to 6.42).


CONCLUSIONS
The presence of a base excess level of less than -6 is associated with increased mortality in elderly patients with initial blood pressure between 110 and 140mmHg, diagnosed with thoracic trauma and who require admission to ICU. Routine measurement of this parameter in this population may show the clinical usefulness of assessing possible hidden hypoperfusion.
Departamento de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España. Electronic address: metalkender@yahoo.es.
Y
Y
Peñasco
Departamento de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España.
A
A
González-Castro
Departamento de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España.
J C
JC
Rodríguez-Borregán
Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Cantabria, Santander, España.
J
J
Llorca
D000137:Acid-Base Imbalance; D000368:Aged; D015415:Biomarkers; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D011379:Prognosis; D013898:Thoracic Injuries / Q000378:metabolism*
D015415:Biomarkers
Base excess; Chest trauma; Exceso de bases; Prognostic index; Traumatismo torácico; Índice pronóstico