Levi Yochai, Jeroukhimov Igor, Peleg Kobi, Rozenfeld Michael, Shavit Itai, Kozer Eran
Pediatric Emergency Unit, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel.
J Emerg Med. 2013 Oct;45(4):496-501. doi: 10.1016/j.jemermed.2013.04.035. Epub 2013 Aug 2.
Base excess is considered a predictor of mortality and severity of injury in trauma patients. Base excess had been widely examined in different settings. Only few studies have examined the role of base excess in pediatric trauma patients.
To evaluate the value of admission base excess in pediatric trauma patients with respect to intensive care unit (ICU) admission rate and length of hospital stay.
A retrospective study of pediatric trauma patients was conducted at a Level II trauma center. All patients aged 0-16 years for which a trauma team was activated over the years 2006-2009 were included. Study database included admission base excess, mechanism of injury, location and nature of injury, injury severity score, length of hospital stay, and ICU admission.
The study group consisted of 359 patients. There was a weak linear correlation between admission base excess, length of stay in the hospital, and ICU admission. Base excess seemed to show a stronger correlation for the youngest age group (0-6 years) and no correlation for the middle age group. There was a positive but weak correlation (R Spearman = 0.26) between admission base excess and Injury Severity Score (ISS). However, 40% of the children with an ISS score >25 had normal admission base excess values. The area under the curve of the receiver operating characteristic curves of base excess for predicting ICU admission was 0.66.
The admission base excess in pediatric trauma patients seems to be a weak prognostic factor in our facility.
碱剩余被认为是创伤患者死亡率和损伤严重程度的预测指标。碱剩余已在不同情况下得到广泛研究。仅有少数研究探讨了碱剩余在小儿创伤患者中的作用。
评估小儿创伤患者入院时碱剩余对于重症监护病房（ICU）入住率和住院时间的价值。
在一家二级创伤中心对小儿创伤患者进行了一项回顾性研究。纳入了2006年至2009年期间所有激活创伤团队的0至16岁患者。研究数据库包括入院时碱剩余、损伤机制、损伤部位和性质、损伤严重程度评分、住院时间以及ICU入住情况。
研究组由359名患者组成。入院时碱剩余与住院时间和ICU入住之间存在弱线性相关性。碱剩余似乎在最年幼年龄组（0至6岁）中显示出更强的相关性，而在中年组中无相关性。入院时碱剩余与损伤严重程度评分（ISS）之间存在正相关但较弱的相关性（斯皮尔曼R = 0.26）。然而，40%的ISS评分>25的儿童入院时碱剩余值正常。碱剩余预测ICU入住的受试者工作特征曲线下面积为0.66。
在我们的机构中，小儿创伤患者入院时碱剩余似乎是一个较弱的预后因素。
