둔상성 중증 외상환자에서 내원 초기에 시행한동맥혈 염기결핍과 예후의 관계 = The Usefulness of the Admission Base Deficit as a Marker of Mortality in Severely Injured Patients with Blunt Trauma

다국어 초록 (Multilingual Abstract)

Purpose: The base deficit (BD) at admission in severely injured patients has been shown to predict the adequacy of resuscitation and outcome, but this relationship is not well established in the Korean experience. The purpose of this study was to define the association between arterial blood gas (ABG) values and the mortality for patients with severe blunt trauma at a developing trauma center in Korea. Methods: A retrospective review of 415 adult patients with severe blunt trauma was conducted using electronic medical records from Jan. 2010 to Dec. 2011. Results: A total of 256 patients had ABG drawn within 1 hour of arrival. Patients who expired displayed a higher lactate level (4.86 vs. 3.31, p<0.0001), a worse BD (-7.99 vs. -5.37, p=0.001), and a lower pH (7.31 vs. 7.34, p=0.011) at arrival compared with those who survived. A statistically significant association was also observed between BD and blood product usage (p=0.001). Conclusion: The base deficit at admission is a useful marker of mortality and outcome in severely injured patients with blunt trauma in Korea.

참고문헌 (Reference)

1 정경원, "현재의 국내 응급의료체계에서 중증외상환자의 이송 지연" 대한외상학회 24 (24): 25-30, 2011

2 Lee EH, "The usefulness of initial arterial base deficit in trauma patients" 19 : 67-73, 2006

3 Husain FA, "Serum lactate and base deficit as predictors of mortality and morbidity" 185 : 485-491, 2003

4 Moon JD, "Prognostic Value of Base Deficit in Severe Trauma Patients" 12 : 243-250, 2001

5 Korea Centers for Disease Control andPrevention, Korea Institute for Health andSocial Affairs, "Injury Surveillance Report" 2012

6 Kincaid EH, "Elevated arterial base deficit in trauma patients: a marker of impaired oxygen utilization" 187 : 384-392, 1998

7 Rutherford EJ, "Base deficit stratifies mortality and determines therapy" 33 : 417-, 1992

8 Rixen D, "Base deficit development and its prognostic significance in posttrauma critical illness: an analysis by the trauma registry of the Deutsche Gesellschaft fur unfallchirurgie" 15 : 83-, 2001

9 Davis JW, "Base deficit as an indicator of significant abdominal injury" 20 : 842-, 1991

10 Davis J, "Base deficit as a sensitive indicator of compensated shock and tissue oxygen utilization" 173 : 473-, 1991

11 Paydar S, "Base Deficit: A Better Indicator for Diagnosis and Treatment of Shock in Trauma Patients" 70 : 1580-,

12 Tremblay LN, "Assessment of initial base deficit as a predictor of outcome: Mechanism of Injury does make a difference" 68 : 689-694, 2002

13 Ziglar MK, "Application of base deficit in resuscitation of trauma patients" 6 : 81-84, 2000

14 Davis JW, "Admission base deficit predicts transfusion requirements and risk of complications" 41 : 769-, 1996

15 Ouellet JF, "Admission base deficit and lactate levels in Canadian patients with blunt trauma: Are they useful markers of mortality?" 72 : 1532-1535,