RISC: Age/NISS/Head injury/severe pelvic injury/GCS/PTT/BD/cardiac arrest/ bleeding (Hb/SBP/MT) EMTRAS: Age/prehospital GCS/BD/PT RIXEN score: Age/GCS/ISS/BD/PT Rixen D et al Base deficit Trauma DGU 1993-7 BD documented at hospital admission in is interesting to mark that the most “It 2001 development and N = 2069 1264 (61.1%) patients severely injured patients with the its prognostic Mean ISS 22 BD documented at ICU admission in poorest outcome were still relatively significance in Age 39 1536 (74.2%) patients haemodynamically stable on posttrauma critical Mortality rate 18.6% admission. That is, their mean blood illness: an analysis pressures, although statistically by the trauma Study designed to look at Mean HR significantly different from the least registry of the prognostic implications of BD on 1 96 injured patients, were still acceptable. – Deutsche admission to hospital, on 2 91 This would allow one to conclude – Gesellschaft Fur admission to ICU and to assess 3 97 that blood pressure is a poor marker – Unfallchirurgie response to treatment. 4 99 of perfusion” – 5 105 – Grouped into 5 arbitrary groups words the real clinical utility “In depending on initial BD: SBP of measuring BD in multiple trauma 1 BD <-2 1 121 patients is to identify the subset of – 2 BD -2-2 2 127 patients who require aggressive – 3 BD 2-6 3 123 haemodynamic monitoring and – 4 BD 6-10 4 113 resuscitative efforts. It is particularly – 5 BD >10 5 101 important in the subset of patients in – which blood pressure is normal and Hospital mortality: yet there is a significant BD.” 1 14% – 2 13% – 3 16% – 4 30% – 5 64% – Prothrombin time Quicke % 1 74% – 2 81% – 3 76% – 4 69% – 5 47% –
RISC: Age/NISS/Head injury/severe pelvic injury/GCS/PTT/BD/cardiac arrest/ bleeding (Hb/SBP/MT) EMTRAS: Age/prehospital GCS/BD/PT RIXEN score: Age/GCS/ISS/BD/PT Rixen D et al 2001 Base deficit development and its prognostic significance in posttrauma critical illness: an analysis by the trauma registry of the Deutsche Gesellschaft Fur Unfallchirurgie Trauma DGU 1993-7 N = 2069 Mean ISS 22 Age 39 Mortality rate 18.6% Study designed to look at prognostic implications of BD on admission to hospital, on admission to ICU and to assess response to treatment. Grouped into 5 arbitrary groups depending on initial BD: 1 BD <-2 2 BD -2-2 3 BD 2-6 4 BD 6-10 5 BD >10 BD documented at hospital admission in 1264 (61.1%) patients BD documented at ICU admission in 1536 (74.2%) patients Mean HR 1 – 96 2 – 91 3 – 97 4 – 99 5 – 105 SBP 1 – 121 2 – 127 3 – 123 4 – 113 5 – 101 Hospital mortality: 1 – 14% 2 – 13% 3 – 16% 4 – 30% 5 – 64% Prothrombin time Quicke % 1 – 74% 2 – 81% 3 – 76% 4 – 69% 5 – 47% “It is interesting to mark that the most severely injured patients with the poorest outcome were still relatively haemodynamically stable on admission. That is, their mean blood pressures, although statistically significantly different from the least injured patients, were still acceptable. This would allow one to conclude that blood pressure is a poor marker of perfusion” “In words the real clinical utility of measuring BD in multiple trauma patients is to identify the subset of patients who require aggressive haemodynamic monitoring and resuscitative efforts. It is particularly important in the subset of patients in which blood pressure is normal and yet there is a significant BD.”