• Erhan Altunbas, Serhad Omercikoglu, Haldun Akoglu, and Arzu Denizbasi.
• Erhan Altunbas, MD. Department of Emergency Medicine, Atasehir Acibadem Surgery Health Care Center, Istanbul, Turkey. Department of Emergency Medicine, Marmara University Faculty of Medicine, Pendik Education and Research Hospital, Istanbul, Turkey.
• Pak J Med Sci. 2018 May 1; 34 (3): 676-681.

ObjectiveTrauma scores are prone to misreading. Therefore, a readily available, objective way to estimate the mortality of the trauma patients is needed. We aimed to evaluate the prognostic utility of lactate levels, and clearance for 30-days mortality, and compare with the physiological trauma scores.MethodsAll adult trauma patients (two hundred) admitted to ED were enrolled. Initial and 2-hour serum lactate levels were measured and components of GAP, MGAP, RTS, VIEWS and VIEWS-L trauma scores were calculated.ResultsFinal study population was 200 patients with a median age of 33 years. Mortality was 7/200 (3.5%) in 30-days. Both initial (2.3 vs. 7.7 mmol/L) and 2h-lactate (1.7 vs. 8.4 mmol/L) levels were significantly lower, and lactate clearance was significantly higher (23.8% vs. -12.0%) in survivors. Also, the change in the lactate level from 0h to 2h (2.3 vs. 1.7mmol/L) was significant in survivors, contrary to non-survivors (7.7 vs. 8.4mmol/L). VIEWS-L, VIEWS, two hour-lactate level and EMTRAS showed high specificity at the 100% sensitivity cut-offs, therefore, were the most valuable prognostic parameters in this study.ConclusionCalculation of 2h-lactate clearance and evaluation of a 2h-lactate level may not be needed to predict long-term mortality if the initial lactate level is below 2.8mmol/L.

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