Prognostic Analysis of Blood Lactate Level Combined with Trauma Degree Score in Patients with Hemorrhagic Shock Caused by Traumatic Fracture
Objective:To investigate the prognostic effect of blood lactate level combined with injury severe score(ISS)in patients with hemorrhagic shock caused by traumatic fracture.Methods:The clinical data of 84 patients with hemorrhagic shock caused by traumatic fracture admitted to Lanling County People's Hospital from March 2020 to March 2023 were retrospectively analyzed,and they were divided into a survival group(n=65)and a death group(n=19)according to their prognosis after 28 days of treatment.General data,laboratory indicators,serum lactate level and ISS at admission and 6,12 and 24 h after admission were collected in the two groups.Univariate and multivariate Logistic regression analysis was performed to screen independent predictors.Receiver operating characteristic curve(ROC)was plotted to compare the predictive value of blood lactic acid level alone,ISS and their combination in patients with hemorrhagic shock caused by traumatic fracture.Results:The mean arterial pressure(MAP)of the death group was lower than that of the survival group,the blood lactic level and ISS,APACHE-Ⅱ score of Acute Physiology and Chronic Health Evaluation-Ⅱat 12 and 24 h after admission were higher than those of the survival group,with statistical significance(P<0.05).Logistic regression showed that MAP,blood lactate level 12 h after admission,ISS and APACHE-Ⅱ score were independent predictors of prognosis in patients with hemorrhagic shock caused by traumatic fracture(P<0.05).ROC curve analysis showed that serum lactate level combined with ISS score at 12 h after admission had a certain predictive effect on poor prognosis of patients with hemorrhagic shock caused by traumatic fracture,and the combined predictive area under the curve was higher than that of a single variable.Conclusion:MAP,blood lactic level 12 h after admission,ISS,APACHE-Ⅱ score are the prognostic factors of patients with hemorrhagic shock caused by traumatic fracture,the accuracy of blood lactic acid level combined with ISS score in predicting prognosis of patients with hemorrhagic shock caused by traumatic fracture is better than that of a single index,which has high diagnostic value.
Traumatic fractureHemorrhagic shockBlood lactate levelInjury severe score
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