Prognostic value of 2-hour lactate level and lactate clearance for 30-day mortality and comparisonwith trauma scores in multi-trauma patients

Erhan Altunbas, Serhad Omercikoglu, Haldun Akoglu, Arzu Denizbasi


Objective: Trauma scores are prone to misreading. Therefore, a readily available, objective way to estimate the mortality of the trauma patients is needed. We aimed to evaluate the prognostic utility of lactate levels, and clearance for 30-days mortality, and compare with the physiological trauma scores.

Methods: All adult trauma patients (two hundred) admitted to ED were enrolled. Initial and 2-hour serum lactate levels were measured and components of GAP, MGAP, RTS, VIEWS and VIEWS-L trauma scores were calculated.

Results: Final study population was 200 patients with a median age of 33 years. Mortality was 7/200 (3.5%) in 30-days. Both initial (2.3 vs. 7.7 mmol/L) and 2h-lactate (1.7 vs. 8.4 mmol/L) levels were significantly lower, and lactate clearance was significantly higher (23.8% vs. -12.0%) in survivors. Also, the change in the lactate level from 0h to 2h (2.3 vs. 1.7mmol/L) was significant in survivors, contrary to non-survivors (7.7 vs. 8.4mmol/L). VIEWS-L, VIEWS, two hour-lactate level and EMTRAS showed high specificity at the 100% sensitivity cut-offs, therefore, were the most valuable prognostic parameters in this study.

Conclusion: Calculation of 2h-lactate clearance and evaluation of a 2h-lactate level may not be needed to predict long-term mortality if the initial lactate level is below 2.8mmol/L. 


How to cite this:Altunbas E, Omercikoglu S, Akoglu H, Denizbasi A. Prognostic value of 2-hour lactate level and lactate clearance for 30-day mortality and comparison with trauma scores in multi-trauma patients. Pak J Med Sci. 2018;34(3):676-681.   doi:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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