Advanced

Peripheral venous lactate at admission is associated with in-hospital mortality, a prospective cohort study

Barfod, C. ; LundstrØm, L. H. ; Lauritzen, M. M.P. ; Danker, J. K. ; Sölétormos, G. ; Forberg, J. L. LU ; Berlac, P. A. ; Lippert, F. K. ; Antonsen, K. and Lange, K. H.W. (2015) In Acta Anaesthesiologica Scandinavica 59(4). p.514-523
Abstract

Background The prognostic value of blood lactate as a predictor of adverse outcome in the acutely ill patient is unclear. The aim of this study was to investigate if a peripheral venous lactate measurement, taken at admission, is associated with in-hospital mortality in acutely ill patients with all diagnosis. Furthermore, we wanted to investigate if the test improves a triage model in terms of predicting in-hospital mortality. Methods We retrieved a cohort of 2272 adult patients from a prospectively gathered acute admission database. We performed regression analysis to evaluate the association between the relevant covariates and the outcome measure: in-hospital mortality. Results Lactate as a continuous variable was a risk for... (More)

Background The prognostic value of blood lactate as a predictor of adverse outcome in the acutely ill patient is unclear. The aim of this study was to investigate if a peripheral venous lactate measurement, taken at admission, is associated with in-hospital mortality in acutely ill patients with all diagnosis. Furthermore, we wanted to investigate if the test improves a triage model in terms of predicting in-hospital mortality. Methods We retrieved a cohort of 2272 adult patients from a prospectively gathered acute admission database. We performed regression analysis to evaluate the association between the relevant covariates and the outcome measure: in-hospital mortality. Results Lactate as a continuous variable was a risk for in-hospital mortality with an odds ratio (OR) of 1.40 [95% confidence interval (CI) 1.25-1.57, P < 0.0001]. OR for in-hospital mortality increased with increasing lactate levels from 2.97 (95% CI 1.55-5.72, P < 0.001) for lactate between 2 mmol/l and 4 mmol/l, to 7.77 (95% CI 3.23-18.66, P < 0.0001) for lactate > 4 mmol/l. If the condition was non-compensated (i.e. pH < 7.35), OR for in-hospital mortality increased to 19.99 (7.26-55.06, P < 0.0001). Patient with a blood lactate at 4 mmol/l or more had a risk of in-hospital mortality equivalent to the patients in the most urgent triage category. Conclusion We found elevated admission peripheral venous lactate to be independently associated with in-hospital mortality in the acutely ill patient admitted to the emergency department. Patients with a lactate > 4 mmol/l at hospital admission should be considered triaged to the most urgent triage category.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Anaesthesiologica Scandinavica
volume
59
issue
4
pages
10 pages
publisher
Wiley-Blackwell
external identifiers
  • pmid:25786680
  • scopus:84925232797
ISSN
0001-5172
DOI
10.1111/aas.12503
language
English
LU publication?
no
additional info
© 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
id
7f109fc2-3e32-4b78-b27a-832c9aacabad
date added to LUP
2021-03-31 16:41:57
date last changed
2021-04-01 13:11:50
@article{7f109fc2-3e32-4b78-b27a-832c9aacabad,
  abstract     = {<p>Background The prognostic value of blood lactate as a predictor of adverse outcome in the acutely ill patient is unclear. The aim of this study was to investigate if a peripheral venous lactate measurement, taken at admission, is associated with in-hospital mortality in acutely ill patients with all diagnosis. Furthermore, we wanted to investigate if the test improves a triage model in terms of predicting in-hospital mortality. Methods We retrieved a cohort of 2272 adult patients from a prospectively gathered acute admission database. We performed regression analysis to evaluate the association between the relevant covariates and the outcome measure: in-hospital mortality. Results Lactate as a continuous variable was a risk for in-hospital mortality with an odds ratio (OR) of 1.40 [95% confidence interval (CI) 1.25-1.57, P &lt; 0.0001]. OR for in-hospital mortality increased with increasing lactate levels from 2.97 (95% CI 1.55-5.72, P &lt; 0.001) for lactate between 2 mmol/l and 4 mmol/l, to 7.77 (95% CI 3.23-18.66, P &lt; 0.0001) for lactate &gt; 4 mmol/l. If the condition was non-compensated (i.e. pH &lt; 7.35), OR for in-hospital mortality increased to 19.99 (7.26-55.06, P &lt; 0.0001). Patient with a blood lactate at 4 mmol/l or more had a risk of in-hospital mortality equivalent to the patients in the most urgent triage category. Conclusion We found elevated admission peripheral venous lactate to be independently associated with in-hospital mortality in the acutely ill patient admitted to the emergency department. Patients with a lactate &gt; 4 mmol/l at hospital admission should be considered triaged to the most urgent triage category.</p>},
  author       = {Barfod, C. and LundstrØm, L. H. and Lauritzen, M. M.P. and Danker, J. K. and Sölétormos, G. and Forberg, J. L. and Berlac, P. A. and Lippert, F. K. and Antonsen, K. and Lange, K. H.W.},
  issn         = {0001-5172},
  language     = {eng},
  month        = {04},
  number       = {4},
  pages        = {514--523},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {Peripheral venous lactate at admission is associated with in-hospital mortality, a prospective cohort study},
  url          = {http://dx.doi.org/10.1111/aas.12503},
  doi          = {10.1111/aas.12503},
  volume       = {59},
  year         = {2015},
}