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Serum lactate in the emergency department as a prognostic factor in patients with sepsis without hypotension


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Información de la publicación
Tipo de publicación

Científica

Tipología

Investigación y estudios

Medio de publicación

Impreso: Revista de divulgación científica

Resumen

BACKGROUND AND OBJECTIVE:

The relationship between lactate and mortality in patients without hypotension has not been appropriately explored. Our aim was to determine the usefulness of serum lactate as a prognostic factor of 28-day mortality in patients admitted to the Emergency Department with clinical diagnosis of sepsis without septic shock.

PATIENTS AND METHODS:

We performed a secondary analysis of the study The epidemiology of sepsis in Colombia, a prospective cohort of patients from 10 general hospitals in 4 Colombian cities. We analyzed patients without hypotension with serum lactate available and admitted with community-acquired infections, which were confirmed according to the Centers for Disease Control and Prevention CDC criteria. A logistical regression was performed adjusting for age, sex, comorbidities and severity scores.

RESULTS:

We included 961 patients aged 57.2 ± 21.0 years, 54.2% were females, mean SOFA score was 3.0 ± 2.3 and APACHE score was 11.1±6.4. We observed a linear relationship between serum lactate and the odds of death, and after adjustment there was a significant and independent association between lactate and mortality (odds ratio 1,16, 95% confidence interval 1.02-1.33).

CONCLUSION:

Serum lactate is independently and significantly associated with 28-day mortality among patients with infection who present to the Emergency Department without hypotension. Besides, mortality increases in a linear way with serum lactate from any detectable value.

Copyright © 2012 Elsevier España, S.L. All rights reserved.

Autores

Gisela De la Rosa Echavez
Rodolfo Dennis
Carmelo Dueñas Castell
Marcela Granados
Dario Londoño
Francisco Molina
Guillermo Ortiz Ruiz
Fabian Jaimes

Registro ISSN

00257753

SNIES Área

Medicine

Fecha de publicación 17 de julio de 2014
Fecha de aceptación 17 de julio de 2014
Medio indexado (nombre)

Medicina Clínica

English information
Title

Serum lactate in the emergency department as a prognostic factor in patients with sepsis without hypotension

Abstract

BACKGROUND AND OBJECTIVE:
The relationship between lactate and mortality in patients without hypotension has not been appropriately explored. Our aim was to determine the usefulness of serum lactate as a prognostic factor of 28-day mortality in patients admitted to the Emergency Department with clinical diagnosis of sepsis without septic shock.
PATIENTS AND METHODS:
We performed a secondary analysis of the study The epidemiology of sepsis in Colombia, a prospective cohort of patients from 10 general hospitals in 4 Colombian cities. We analyzed patients without hypotension with serum lactate available and admitted with community-acquired infections, which were confirmed according to the Centers for Disease Control and Prevention CDC criteria. A logistical regression was performed adjusting for age, sex, comorbidities and severity scores.
RESULTS:
We included 961 patients aged 57.2 ± 21.0 years, 54.2% were females, mean SOFA score was 3.0 ± 2.3 and APACHE score was 11.1±6.4. We observed a linear relationship between serum lactate and the odds of death, and after adjustment there was a significant and independent association between lactate and mortality (odds ratio 1,16, 95% confidence interval 1.02-1.33).
CONCLUSION:
Serum lactate is independently and significantly associated with 28-day mortality among patients with infection who present to the Emergency Department without hypotension. Besides, mortality increases in a linear way with serum lactate from any detectable value.
Copyright © 2012 Elsevier España, S.L. All rights reserved.

Keywords

Emergencies, Lactic acid, Mortality, Prognostic

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