Peripheral venous lactate at admission is associated with in-hospital mortality, a prospective cohort study
(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)
- author
- 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.
- publishing date
- 2015-04-01
- 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
- 2024-06-29 11:14:35
@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 < 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.</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}}, }