Serum lactate, not base deficit, rapidly predicts survival after major burns

Background: Clinical studies document correlation of serum lactate and base deficit with mortality in trauma and sepsis. No study of the prognostic value of these two serum markers has been reported in burn injury. Methods: Resuscitation data from 49 patients admitted to the adult Burn ICU were analyzed. Lactate and base deficit were analyzed upon admission and every 2h during the initial 48h after admission. Resuscitation was managed per standard routine, blinded to these data, guided by the Parkland formula. Initial statistical analysis with Cox's regression model was used to determine the relationship between survival, resuscitation parameters, and demographics. Then, a logistic regression was used to determine if any of these variables were quickly predictive (initial values) of the risk of death. Results: Two variables were predictive of mortality by the Cox regression model: (1) serum lactate value and (2) patient age. Furthermore, analysis by logistic regression revealed that the initial serum lactate value was separately predictive of mortality. Conclusion: In this study, serum lactate but not base deficit, was a predictor of mortality following major burns. Moreover, initial serum lactate values were also predictive of mortality separately.