• Lorraine N Tremblay, David V Feliciano, and Grace S Rozycki.
• Department of Surgery, Grady Memorial Hospital, and Emory University School of Medicine, Atlanta, GA 30303, USA.
• Am. J. Surg. 2003 Dec 1;186(6):597-600; discussion 600-1.

BackgroundThis study assessed the outcome of injured patients in shock with an admission base deficit of -20 or less (approximate pH <7.0) at a level 1 trauma center.MethodsA retrospective review was made of the trauma registry, supplemented by chart review, of all trauma patients admitted with a base deficit -20 or less from 1995 to 2002. Data collected included mechanism of injury, base deficit, Injury Severity Score(ISS), operative procedures, and outcome. Data are presented as mean +/- SD.ResultsOver the study period, 110 trauma patients (88% male; 31 +/- 13 years; 34% blunt trauma; ISS 26 +/- 15) were admitted with base deficit of -20 or less. Overall survival was 38%, with the majority of deaths occurring within hours of admission.ConclusionsAn admission base deficit of -20 or less is associated with high mortality in patients with gunshot wounds (64%) or blunt trauma (70%). The majority of patients who die will do so within hours of admission. Beyond 24 hours, the survival rates of 73% for patients with blunt trauma, 79% for those with gunshot wounds, and 90% for those with stab wounds justify continuing resuscitation and reoperations.

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