{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T18:53:05Z","timestamp":1784746385654,"version":"3.55.0"},"reference-count":0,"publisher":"California Digital Library (CDL)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Western Journal of Emergency Medicine"],"abstract":"<p>Introduction: Severe trauma-induced blood loss can lead to metabolic acidosis, shock, and death. Identi\ufb01cation of abnormalities in the bicarbonate and serum markers may be seen before frank changes in vital signs in the hemorrhaging trauma patient, allowing for earlier lifesaving interventions. In this study the author aimed to evaluate the usefulness of serum bicarbonate and other lab markers as predictors of mortality in trauma patients within 30 days after injury. Methods: This retrospective, propensity-matched cohort study used the TriNetX database, covering approximately 92 million patients from 55 healthcare organizations in the United States, including 3.8 million trauma patients in the last two decades. Trauma patients were included if they had lab measurements available the day of the event. The analysis focused on mortality within 30 days post-trauma in comparison to measured lab markers. Cohorts were formed based on ranges of bicarbonate, lactate, and base excess levels. Results: Before propensity score matching, a total of 1,275,363 trauma patients with same-day bicarbonate, lactate, or base excess labs were identi\ufb01ed. A signi\ufb01cant difference in mortality was found across various serum bicarbonate lab ranges compared to the standard range of 21\u201327 milliequivalents per liter (mEq\/L), post-propensity score matching. The relative risk of death was 6.806 for bicarbonate \u22645 mEq\/L; 8.651 for 6\u201310; 6.746 for 11\u201315; 2.822 for 16\u201320; and 1.015 for bicarbonate \u226528. Serum lactate also displayed signi\ufb01cant mortality outcomes when compared to a normal level of \u22642 millimoles per liter. Base excess showed similar signi\ufb01cant correlation at different values compared to a normal base excessof \u22122 to 2 mEq\/L. Conclusion: This study, approximately 100 times larger than prior studies, associated lower bicarbonate levels with increased mortality in the trauma patient. While lactate and base excess offer prognostic value, lower bicarbonate values have a higher relative risk of death. The greater predictive value of bicarbonate and accessibility during resuscitations suggests that it may be the superior prognostic marker in trauma.<\/p>","DOI":"10.5811\/westjem.18363","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T19:37:00Z","timestamp":1721072220000},"source":"Crossref","is-referenced-by-count":4,"title":["Bicarbonate and Serum Lab Markers as Predictors of Mortality in the Trauma Patient"],"prefix":"10.5811","volume":"25","author":[{"given":"Matthew M.","family":"Talbott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela N.","family":"Waguespack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peyton A.","family":"Armstrong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna K.","family":"Paul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shania M.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgiy","family":"Golovko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Person","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietrich","family":"Jehle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"29705","published-online":{"date-parts":[[2024,5,20]]},"container-title":["Western Journal of Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T13:33:51Z","timestamp":1721223231000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/1cq3b5k5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,20]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,7,9]]}},"URL":"https:\/\/doi.org\/10.5811\/westjem.18363","relation":{},"ISSN":["1936-9018"],"issn-type":[{"value":"1936-9018","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,20]]}}}