Background: Increase in lactate (LAC) within the central nervous system after head trauma is an established marker of traumatic brain injury (TBI).
Objective: To investigate the utility of arterial base deficit (BD) and LAC in identifying TBI in patients with isolated head injury (IHI).
Materials and methods: TBI was defined as Glasgow Coma Scale ⩽8, head Abbreviated Injury Severity Score >2 or brain haematoma on CT scan. Patients were divided into two groups: IHI with and without TBI. Data were reported as means (SDs). 131 patients with IHI were studied (mean (SD) age 39 (19) years, 78% male).
Results: 17% of the patients sustained TBI. The mean differences for arterial BD (0.65 mmol/l, 95% CI −0.8 to 2.1) and LAC (0.34 mmol/l, 95% CI −0.7 to1.4) in patients with and without TBI were not significant. Analysis of receiver operating characteristic curves confirmed that arterial BD and LAC were unable to detect TBI in patients with IHI.
Conclusion: Arterial BD and LAC are poor predictors of TBI in isolated head trauma.
- AISS, Abbreviated Injury Severity Score
- BD, base deficit
- CNS, central nervous system
- CSF, cerebrospinal fluid
- ED, emergency department
- GCS, Glasgow Coma Scale
- IHI, isolated head injury
- KCHC, Kings County Hospital Center
- LAC, lactate
- ROC, receiver operating characteristic
- TBI, traumatic brain injury
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Competing interests: None.