Volume 24, Issue 101, January - February, 2020

Evaluation of the effect of potassium abnormalities based on the Revised Trauma Score (RTS) in the multiple Trauma

Amin Saberinia¹, Saeed Safari¹, Mohammad Mehdi Forouzanfar¹, Anita Sabzghabaei¹, Sahar Mirbaha¹, Elham Gholami Kelishami^1♦

¹Department of Emergency Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Shohadaye Tajrish Hospital, Tehran, Iran

^♦Corresponding author
Department of Emergency Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Shohadaye Tajrish Hospital, Tehran, Iran Email: drelhamgholamimd@gmail.com

ABSTRACT

Background and objective: A trauma causes changes, which are known as the metabolic responses to an injury. In this regard, extracellular potassium level abnormalities can cause various clinical problems in trauma patients. Here, the main objective of this research was to evaluate the effect of potassium abnormalities on the severity of the trauma (based on RTS scoring system) in multiple trauma patients. Material and Methods: In the current study, a total of 311 multiple trauma cases, who were transferred by Emergency Medical Services (EMS) to the emergency ward of Shohadaye Tajrish Hospital in 2017, were examined. The patients were assessed against the exclusion criteria and 203 patients eventually participated in the research. Also, a checklist containing the following information was also completed for each patient: gender, age, trauma type (blunt-penetrating), patient transportation method, arrival Venous blood gases (VBG), and RTS. Thereafter, the therapeutic and surgical considerations were recorded. In this study, blood samples of the patients were collected upon arrival to measure Potassium (K), VBG, Creatinine (Cr), Calcium (CA), Blood urea nitrogen (BUN), and Blood sugar (BS). Results: The severity of the trauma (RTS) varied between 3 and 4 in 12% of the patients. It also varied between 5 and 6 and from 7 to 8 in 30% and 58% of the participants, respectively. As seen, the severity of the trauma in more than half the patients ranged from 7 to 8. Moreover, the average values of the RR, BUN, Cr, VBG, and PR variables were 18.77±6.14, 21.05±14.72, 1.06±0.31, 7.31±0.13, and 94.25±24.92, respectively. The Glasgow Coma Scale (GCS) values in 55, 25, and 20 % of the patients ranged from 11 to 15, 6 to 10, and 3 to 5, respectively. The potassium level was normal in 81% of the other patients. There was no statistically significant difference between the trauma severity scores (RTS) using different levels of potassium (p=0.110). In addition, there was no significant difference between the different levels of potassium in terms of mortality rates (p=0.634). Also, Hypokalemia (K<3.5 mEq/L) and hyperkalemia (K> mEq/L) were observed in 15 and 4 % of the patients, respectively. Conclusion: In general, the results from the present research suggest that hypokalemia cannot serve as a prognostic predictor of trauma severity in multiple trauma patients. However, definitive assessments call for more extensive studies.

Keywords: Multiple trauma, Potassium abnormalities, RTS.

Medical Science, 2020, 24(101), 118-126

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