A Study on Significance of Blood Lactate Levels and Lactate Clearance in the Prognosis of Polytrauma Patients

Introduction: Polytrauma involves injuries across multiple body regions, often life-threatening, and remains a major cause of mortality, especially among individuals aged 15-29. Identifying markers of hypoperfusion is crucial in the management of such patients. Serum lactate, a byproduct of anaerobic metabolism, has been widely studied as an indicator of tissue hypoxia. This study evaluates the prognostic value of serial lactate clearance in polytrauma patients. Methods: A prospective observational study was conducted on 100 polytrauma patients (ISS >16) admitted to the Emergency Department at Alluri Sitarama Raju Academy of Medical Sciences betweenJuly 2022 and June 2024.Lactate levels were recorded at admission, 2, 24, and 48 hours, and clearance was calculated at each interval.Patients were followed up for 30 days.Statistical analysis was performed using the Mann-Whitney test, with a significance level set at p<0.05.Results: Lactate clearance at 2 hours (29.8728.17 in survivors vs. 13.538.23 in non-survivors, p=0.0501) and 24 hours (54.5212.76 vs. 37.0711.27,p=0.0482) showed statistically significant differences.Lactate levels at admission, 2, 24, and 48 hours were significantly higher in non-survivors.Clearance at 48 hours did not show statistical significance (p=0.7532).Failure to normalize lactate was associated with increased mortality.Conclusions: Lactate clearance, particularly at 2 and 24 hours, is a valuable prognostic marker in polytrauma patients and correlates significantly with survival outcomes.Early lactate normalization indicates better prognosis, while persistent elevation is associated with higher mortality.Further multicentric studies are needed to strengthen these findings and integrate lactate clearance into trauma management protocols.