Health-related quality of life is related to the lactate level at ICU admission in brain traumatic injury and major trauma patients

Introduction

The aim of the study was to relate the health-related quality of life (HRQL) evaluated 6 months after major trauma and traumatic brain injury with the initial parameters of clinical picture and with the length of ICU stay and sedation. HQRL is reduced in ICU patients, admitted for any reason, after 6 months from discharge [1, 2]. The summarized Short-Form 36 (SF-36), comprehending physical functioning, general health, and social functioning, is useful to evaluate HQRL after major trauma [3].

Methods

One hundred and twenty-one patients were admitted to an emergency department ICU in 2007 with major trauma (injury severity score >15) and severe to moderate brain injury (Glasgow coma scale <13). Of these, 25 died in the days following trauma. Thirty-four of these were evaluated, during the follow-up visit, 6 months after discharge from the ICU. HRQL was assessed by the SF-36 questionnaire. At admission to the ICU, from the ICU database (FileMaker Pro 5.5v2; FileMaker, Inc., USA) with authorization of the Careggi Teaching Hospital Committee of the Emergency Department, the following parameters were collected for every patient: age, sex, abbreviated injury scale, injury severity score, Simplified Acute Physiology Score II, in the field Glasgow coma scale, Marshall score at the first head CT, worst values of lactates and ScvO₂ within 24 hours from trauma. Also, the length of sedation and ICU stay were collected. The mean summarized SF-36 was related with the Pearson test to the other parameters.

Results

Only lactate levels showed a significant correlation with the mean summarized SF-36 (y = -0.0035x + 4.83; R = 0.59; P = 0.007).

Conclusion

In the patients affected by major trauma and brain traumatic injury, the HRQL appears to be related to the severity of the clinical picture on the first day of trauma assessed by lactate levels regardless of the length of ICU stay and sedation.