Hyperlactataemia and Hypocalcaemia as Predictors of Mortality in Adult Polytrauma Patients: A Prospective Observational Study

Background: Early identification of high-risk polytrauma patients remains a major challenge in critical care.This study aimed to evaluate the prognostic value of serum lactate and serum calcium in predicting inhospital mortality among adult polytrauma patients admitted to the intensive care unit (ICU).Methods: One hundred adult polytrauma patients aged 18-65 years with an Injury Severity Score (ISS) >16 and admitted within 48 hours of injury were enrolled.Baseline serum calcium and serial arterial lactate levels were measured during ICU stay.ISS, Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) score, days of mechanical ventilation, ICU stay, and mortality were noted.Results: Overall in-hospital mortality was 62%.Non-survivors demonstrated significantly higher serial serum lactate concentrations throughout ICU admission than survivors (p < 0.001).Baseline serum lactate showed a significant negative correlation with survival (r = -0.379,p < 0.001), while peak lactate demonstrated an even stronger association (r = -0.498,p < 0.001).Baseline serum calcium was significantly associated with mortality and demonstrated inverse correlations with APACHE II, SOFA, and ISS, indicating that lower calcium levels were associated with greater injury severity and poorer clinical outcomes.Peak serum lactate also correlated positively with established severity scoring systems.Conclusions: Hyperlactataemia and hypocalcaemia are significant predictors of mortality in critically ill polytrauma patients.Both biomarkers correlate closely with validated trauma severity scores and provide valuable prognostic information early during ICU admission.