The Effect of Prehospital Fluid Resuscitation on Mortality and Post-trauma Recovery Time in Trauma Patients

Objective:It was aimed to evaluate the effect of pre-hospital fluid resuscitation on serum lactate level, mortality, radiological imaging, and late post-trauma recovery (PRT) in patients with trauma, who were admitted to the emergency department.Method:In this study, 532 patients over the age of 18 years, who were admitted to the emergency department due to trauma between January 1, 2016, and December 31, 2017, were included. The average age of the patients was 37.19±13.91 years, 378 (71%) were male and 154 (29%) were female. The demographic characteristics, fluid resuscitation, and serum lactate levels, trauma patterns, mortality, and PRT results of these patients were evaluated retrospectively.Results:PRT duration was shorter (22.48±7.17 days) in patients who underwent prehospital fluid resuscitation and longer (26.85±7.58 days) in those who did not receive it. Also, lactate levels were significantly lower in liquid areas (2.18±1.05 mmol/L) compared to those that did not take it (2.61±1.40 mmol/L). PRT time was 24.20±7.34 days in the group without mortality, and 33.43±12.87 days in the group with mortality. Serum lactate level was 2.29±1.10 mmol/L in the group without mortality, and 5.51±1.87mmol/L in the group without mortality. Serum lactate levels were 2.29±1.10 mmol/L in liquid areas and 5.51±1.87 mmol/L in those who did not receive it. Types of trauma were associated with fluid resuscitation and radiological imaging methods (p=0.001). These parameters showed a moderate and/or strong positive correlation among themselves, as well as in terms of lactate, PRT duration, and mortality. ROC curve analysis was performed to predict the development of mortality. The rates of lactate and PRT were over 45% with a sensitivity of 97.7% and a specificity of 94.3% and with a sensitivity of 89.7% and a specificity of 83.6%, respectively.Conclusion:Mortality and morbidity rates can be reduced by early detection of trauma cases with multidisciplinary understanding, adjustment of fluid and lactate levels, and early decision-making on the procedures to be performed.