Diagnostic performance of initial serum lactate for predicting bacteremia in female patients with acute pyelonephritis - 25/07/16
, Jae Baek Lee, MD, PhD a, Young Ho Jin, MD, PhD a, Taeoh Jeong, MD, PhD a, Jaechol Yoon, MD a, Boyoung Park, MD bAbstract |
Objectives |
The purpose of the present study was to investigate the diagnostic value of lactate for predicting bacteremia in female patients with acute pyelonephritis (APN).
Methods |
We conducted a retrospective study of female patients with APN who visited the study hospital emergency department. The demographics, comorbidities, physiologies, and laboratory variables including white blood cell count and segmented neutrophil count, C-reactive protein, and initial serum lactate levels were collected and analyzed to identify associations with the presence of bacteremia.
Results |
During the study period, a total of 314 patients were enrolled. One hundred twenty-three patients (39.2%) had bacteremia. Escherichia coli was the most frequent pathogen. Logistic regression analysis demonstrated that the lactate level was independently associated with the presence of bacteremia (odds ratio, 1.39 [95% confidence interval, 1.08-1.78]). The C-statistic of the lactate level was 0.67 (95% CI, 0.60-0.73). At a cutoff value of 1.4mmol/L, the lactate level predicted bacteremia with a sensitivity (53.7%), specificity (72.3%), positive predictive value (55.5%), negative predictive value (70.8%), positive likelihood ratio (1.93), and negative likelihood ratio (0.64).
Conclusion |
The initial serum lactate level showed poor discriminative performance for predicting bacteremia in female patients with APN.
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| ☆ | Declaration of interest: The authors report no conflicts of interest. The authors are responsible for the content and writing of the manuscript. |
| ☆☆ | Funding: None. |
Vol 34 - N° 8
P. 1359-1363 - août 2016 Retour au numéro
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