Background Triage vital signs are often used to help determine a trauma patient's haemodynamic status. Recent studies have demonstrated that these may not be very specific in determining major injury. The purpose of this study was to determine if there is any correlation between triage vital signs, base deficit (BD) and lactate, and to determine the odds of operative intervention in penetrating trauma patients.
Methods A prospective observational cohort study was undertaken. Baseline vital signs, BD and lactate were recorded in all patients for whom the trauma team was activated. Pearson correlation and coefficient (ρ) were calculated. ORs were calculated.
Results 75 patients were enrolled. Pearson correlations and coefficients calculated for lactate to systolic blood pressure were: −0.052 (ρ=0.0011, 95% CI −0.225 to 0.228); lactate and HR: 0.23 (ρ=0.0166, 95% CI −0.211 to 0.242); lactate and RR: 0.23 (ρ=0.054, 95% CI −0.174 to 0.277). BD to systolic blood pressure were: 0.003 (ρ=0.00001, 95% CI −0.229 to 0.224); BD and HR: −0.19 (ρ=0.038, 95% CI −0.399 to 0.038); BD and RR: −0.019 (ρ=0.0004, 95% CI −0.244 to 0.208). Odds of operative intervention were greater in patients with abnormally high lactate, OR 4.17 (95% CI 1.57 to 11), but not for BD, OR 2.53 (95% CI 0.99 to 6.45), or any of the vital signs.
Conclusions Triage vital signs have no correlation to lactate or BD levels in penetrating trauma patients. Odds of operative intervention are greater in patients with abnormally high serum lactate levels, but not in those with abnormal triage vital signs or BD.
Statistics from Altmetric.com
Competing interests None.
Patient consent This study analysed data already collected per the policy of the departments of trauma surgery and emergency medicine for the management of trauma patients. All trauma patients get triage vital signs and point-of-care lactate.
Ethics approval Ethics approval was provided by the Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.