Lactate and Hypocalcaemia as Possible Prognostic Factors of Mortality and Morbidity in Early Phases of Moderate and Severe Traumatic Brain Injury

Kuhna V, Vinas-Rios JM, Kretschmer T and Heinen CPG

Department of Neurosurgery, Carl-von-Ossietzky-University Oldenburg, Germany

^*Correspondance to: Victoria Kuhna 

 PDF  Full Text DOI: 10.25107/2474-1647.2636

Abstract

Background: Traumatic Brain Injury (TBI) is one of the most common disorders within the vast field of neurology. Recent identification of multiple markers regarding trauma assessment has brought potential tools in outcome prediction. Objective: The aim of this study was to evaluate whether elevated serum lactate is a prognostic factor for mortality and morbidity and investigate its correlation with hypocalcemia (defined as ionized serum calcium <1.10 mmol/L [4.5 mg/dL]) and non-ionized serum calcium <2.1 mmol/L [8.5 mg/dL] in early phases of moderate and severe isolated TBI. Methods: We retrospectively (January 2004 to July 2012) compiled data from 99 patients. Prospectively, (December 2013 to December 2015) we recruited 61 patients with moderate and severe isolated TBI. Beside demographic and clinical features, blood samples were taken following admission, day 3 and day 7 after trauma. Results: Median age at presentation was 47 years (range: 16 to 87). N=88 (55%) were men and 72 (45%) women. N=69 (43%) had a GOS ≤ 3 and n=91 (57%) had a GOS>3. Patients in the GOS ≤ 3-group were significantly older than patients with a GOS>3 (p=0.008). Lactate levels were significantly higher in the GOS ≤ 3-group on day 3 with p=0.002, but not on day 7. Furthermore, there was a significant association between GOS-group and hypocalcemia. Conclusion: Elevated lactate serum levels and hypocalcaemia correlated with dismal outcome. Furthermore, lactate and calcium are easy assessable serum markers. Both could serve as prognostic markers evaluating the severity of isolated TBI and thus predict mortality and disability following TBI.

Keywords

Lactate; Hypocalcaemia traumatic brain injury; Prognostic factor; Glasgow outcome score

Cite the article

Kuhna V, Vinas-Rios JM, Kretschmer T, Heinen CPG. Lactate and Hypocalcaemia as Possible Prognostic Factors of Mortality and Morbidity in Early Phases of Moderate and Severe Traumatic Brain Injury. Clin Surg. 2019; 4: 2636.