Künt çoklu travmalı hastalarda mortalite belirleyicisi olarak laboratuvar parametrelerinin araştırılması

Yıl 2024, Cilt: 17 Sayı: 3, 468 - 475, 05.07.2024

Mümin Murat Yazıcı , Nurullah Parça , Utku Sarp Cerit , Özlem Bilir

https://doi.org/10.31362/patd.1435793

Öz

Amaç: Travma hastalarında vital bulgular hasta yönetiminde yeterli olmayabilir. Bu nedenle travma hastalarının yönetiminde yaşamsal bulguların, bazı laboratuvar parametrelerinin ve görüntüleme yöntemlerinin değerlendirilmesi esastır. Künt multi-travma hastalarının değerlendirilmesinde laktat ve baz fazlalığının (BE) morbidite ve mortalitenin erken bir belirteci olduğu hipotezinden yola çıkarak, künt multi-travma hastalarında mortaliteyi öngörmede laktat ve BE'ye ek olarak laktat albümin oranı ve laktat dehidrogenaz (LDH) albümin oranının değerini araştırmayı amaçladık.
Gereç ve yöntem: Bu tek merkezli, retrospektif bir çalışmadır. Veri toplanmadan önce yerel etik kuruldan onay alınmıştır. Çalışmaya, 1 Ocak 2018 ile 31 Aralık 2021 tarihleri arasında Türkiye'deki üçüncü basamak bir eğitim ve araştırma hastanesinin acil servisine çoklu travma ile başvuran ve dışlama kriterlerini karşılamayan hastalar dahil edildi. Bu çalışmada, künt çoklu travma hastalarında, mortaliteyi öngörmede Laktat, BE, Laktat / albümin oranı ve LDH / albümin oranının tanısal değerliliği hesaplanmıştır.
Bulgular: Mortalite için laktat kesme değeri 4,2 olup %73,3 duyarlılık ve %89,2 özgüllük sergilemektedir. Mortalite için BE kesme değeri -3 olup %80,0 duyarlılık ve %76,9 özgüllük sergilemektedir. Mortalite için laktat albümin oranı kesme değeri 0,11 olup %73,3 duyarlılık ve %90,8 özgüllük sergilemektedir. Mortalite için LDH albümin oranı kesme değeri 7,2 olup %86,7 duyarlılık ve %58,5 özgüllük sergilemektedir.
Sonuç: Laktat albümin oranı mortaliteyi öngörmede laktat ve BE'ye göre daha spesifik iken, LDH albümin oranı mortaliteyi öngörmede laktat ve BE'ye göre daha duyarlıydı.

Anahtar Kelimeler

Laktat albumin oranı, laktat dehidrogenaz albumin oranı, çoklu-travma

Investigation of laboratory parameters as mortality marker in patients with blunt multi-trauma

Öz

Purpose: In trauma patients, vital signs may not be beneficial in patient management. Therefore, evaluating vital signs, some laboratory parameters, and imaging methods is essential in managing trauma patients. Based on the hypothesis that lactate and base excess (BE) is an early marker of morbidity and mortality in the evaluation in blunt multi-trauma patients, we aimed to investigate the value of lactate albumin ratio and lactate dehydrogenase (LDH) albumin ratio in addition to lactate and BE in predicting mortality in blunt multi-trauma patients.
Materials and methods: This was a single-centre, retrospective study. Prior to data collection, approval was obtained from the local ethics committee. Patients admitted with multi-trauma to the emergency department of a tertiary education and research hospital in Türkiye between January 1, 2018, and December 31, 2021, who did not meet the exclusion criteria, were included in the study. This study examined the predictive value of Lactate, BE, Lactate-to-albumin ratio, and LDH-to-albumin ratio in predicting mortality in blunt multi-trauma patients.
Results: The lactate cut-off value for mortality was 4.2, exhibiting 73.3% sensitivity and 89.2% specificity. The BE cut-off value for mortality was -3, exhibiting 80.0% sensitivity and 76.9% specificity. The lactate-albumin ratio cut-off value for mortality was 0.11, exhibiting 73.3% sensitivity and 90.8% specificity. The LDH-albumin ratio cut-off value for mortality was 7.2, exhibiting 86.7% sensitivity and 58.5% specificity.
Conclusion: Lactate albumin ratio was more specific in predicting mortality than lactate and BE, while LDH albumin ratio was more sensitive in predicting mortality than lactate and BE.

Anahtar Kelimeler

Lactate albumin ratio, lactate dehydrogenase albumin ratio, multi-trauma

Etik Beyan

This study was approved by the institutional review board and ethics committee (Number: E-40465587-050.01.04-955 and ID: 2024/29).

Destekleyen Kurum

None declared.

Teşekkür

We would like to express a special thank to Emergency Department of Recep Tayyip Erdoğan University Training and Research Hospital.

Kaynakça

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