Base Deficit in the Elderly: A Marker of Severe Injury and Death

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Abstract

Background

Base deficit has been used as a marker of significant injury and to predict resource utilization and mortality. The significance of base deficit in trauma patients 55 years and older has not been specifically evaluated. The purpose of this study was to determine the utility of base deficit in assessing older trauma patients versus a younger cohort.

Methods

Data were obtained from the trauma registry on trauma patients admitted to a Level I trauma center. Arterial blood gases were obtained within 1 hour of arrival, by protocol, in 2,631 patients, and of these, 274 patients were 55 years or older. Data are presented as means +/- SEM. Statistical analysis was done by paired t test, analysis of variance, and chi squared analysis. Significance was attributed to a p value < 0.05.

Results

Patients older than 55 years were significantly more likely to have sustained blunt trauma (86 vs. 69%; p < 0.001). Despite similar Injury Severity Scores and base deficit values, older patients had markedly greater mortality and intensive care unit lengths of stay. A base deficit of or=to 16 for 76% of patients younger than 55 years and 78% of patients 55 years and older. The negative predictive value of a normal base deficit for Injury Severity Scores Conclusions

A base deficit of

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