Lactate level, aetiology and mortality of adult patients in an emergency department: a cohort study

Emergency Medicine Journal : EMJ
Mathilde PedersenAnnmarie T Lassen

Abstract

Increased lactate is associated with high mortality among patients with suspected infection or trauma in the emergency department (ED), but the association with patients with other aetiologies is less well described. The aim of this study was to describe the relation between lactate, aetiology and 7-day mortality in adult ED patients. A retrospective cohort study of all adult patients who had a lactate measured within 4 h after arrival to the ED at Odense University Hospital between June 2012 and May 2013. The categorisation of suspected aetiology was based on discharge diagnoses. 5360 patients were included; 51.7% were men, and the median age was 67 years (IQR 50-79). 77.2% had low lactate (0-1.9 mmol/L), 16.2% intermediate lactate (2-3.9 mmol/L), and 6.6% high lactate (≥4 mmol/L). 7-day mortality was 2.9% (95% CI 2.4% to 3.5%) for patients with low lactate, 7.8% (95% CI 6.1% to 9.8%) for patients with intermediate lactate, and 23.9% (95% CI 19.6% to 28.8%) for patients with high lactate. The association between lactate level and mortality varied across different diagnostic groups. Based on Area Under the Curve in receiver operating characteristic analysis, lactate level showed to be useful in patients with infection (0.78, 95...Continue Reading

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Citations

Aug 22, 2015·Emergency Medicine Journal : EMJ·Bernard A Foëx
Mar 14, 2018·Journal of Veterinary Emergency and Critical Care·Patricia G RosensteinDez Hughes
May 9, 2018·PloS One·Abdellatif AharazAnnmarie Touborg Lassen
Nov 7, 2017·Scandinavian Journal of Gastroenterology·Line Aabel StokbroStig Borbjerg Laursen
Jul 11, 2020·European Journal of Clinical Investigation·Francisco Martín-RodríguezAncor Sanz-García
Apr 27, 2017·BMC Emergency Medicine·Tibor GondosGábor Halász
Nov 7, 2017·Biomarkers : Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals·Christian Hohenstein, Maria Bernhardt
Mar 8, 2019·Journal of Orthopaedic Surgery and Research·Chia-Peng ChangCheng-Ting Hsiao
Sep 18, 2020·Acta Anaesthesiologica Scandinavica·Gitte Boier TygesenMarianne Lisby
Aug 8, 2018·The American Journal of Emergency Medicine·Julie ContentiJacques Levraut
Jul 6, 2021·The American Journal of Emergency Medicine·Francisco Martín-RodríguezRaúl López-Izquierdo
Nov 2, 2020·The American Journal of Emergency Medicine·Yurdagul Cetin SekerAsim Kalkan
Jun 12, 2021·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Peter Bank PedersenAnnmarie Touborg Lassen

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