Objective: The aim of this study was to find out the effects of pre-hospital fluid resuscitation on serum lactate level, mortality, radiological imaging and late post-trauma recovery time (PRT) in patients with trauma admitted to emergency service.
Methods: 532 patients older than 18 years of age who were admitted to the emergency service due to trauma between January 1, 2016 and December 31, 2017 were included in this study. Mean age of the patients was 37.19±13.91/years, 378(71%) were male and 154(29%) were female. Demographic features, fluid resuscitation and serum lactate levels, trauma types, mortality and PRT results of these patients were evaluated retrospectively.
Results: PRT was shorter in patients who underwent pre-hospital fluid resuscitation (22.48±7.17 days), while it was longer in the patients who did not (26.85±7.58 days). In addition, lactate level was found to be significantly lower in the patients who received fluid (2.18±1.05mmol/L), when compared with those who did not (2.61±1.40mmol/L). PRT was found as 24.20±7.34 days in the patients who received fluid resuscitation, while it was found as 33.43±12.87 days in those who did not. Serum lactate level was found as 2.29±1.10mmol/L in the patients who received fluid and as 5.51±1.87mmol/L in those who did not. Trauma types were found to be associated with fluid resuscitation and radiological imaging methods (p=0.001). These parameters were found to be moderately and/or strongly positively correlated with lactate, PRT and mortality. ROC curve analysis was conducted to predict the development of mortality and it was found as over 45%, with 97.7% sensitivity and 94.3% specificity for lactate and 89.7% sensitivity and 83.6% specificity for PRT.
Conclusion: Mortality and morbidity rates can be reduced by detecting trauma cases with an early multidisciplinary approach, adjusting the fluid and lactate level and making early decisions for the procedures to be performed.
Key words: Trauma, fluid resuscitation, lactate, mortality, post-trauma recovery
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