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The role of the serum lactate level at the first admission to the emergency department in predicting mortality - 13/07/21

Doi : 10.1016/j.ajem.2020.09.088 
Yurdagul Cetin Seker a, , Oner Bozan a, Emel Sam b, Hakan Topacoglu a, Asim Kalkan a
a University of Health Sciences, Okmeydani Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey 
b University of Health Sciences, Erzurum Regional Training and Research Hospital, Department of Emergency Medicine, Erzurum, Turkey 

Corresponding author at: Kaptanpasa Mah, Darulaceze Cad, No:25, Department of Emergency Medicine, Okmeydani Training and Research Hospital Kağıthane, Istanbul 34147, Turkey.Department of Emergency MedicineOkmeydani Training and Research Hospital KağıthaneKaptanpasa Mah, Darulaceze Cad, No:25Istanbul34147Turkey

Abstract

Introduction

Lactate is an easily measurable laboratory parameter that is considered a potentially useful prognostic marker for determining risk in emergency department patients. The aim of this study was to investigate the role of serum lactate in the patients who were admitted to the emergency department at the time of admission.

Methods

Patients who were admitted to the emergency department for various reasons between June 2017 and January 2018 were included in the study. Demographic data, laboratory findings, mortality and hospitalization rates of the patients were analyzed. The primary endpoint was determined as the role of serum lactate in predicting mortality, and the secondary endpoint in predicting hospitalization.

Results

Of the 1382 patients, 47.4% (n = 655) were female and 52.6% (n = 727) were male. The mean age of the patients was 60.99 ± 20.04 (18–100) years. In 59.6% (n = 824) of the patients, the most common hypertension (36%) was an additional disease. Mortality was found in 43 (3.1%) patients. It was observed that 20.5% (n = 284) of the patients were hospitalized. The ages of patients with hospitalization and mortality were found to be statistically significant higher than those without hospitalization and without mortality (p = 0.001; p < 0.01). There was no statistically significant difference between the serum lactate measurements of the patients according to hospitalization (p > 0.05). The serum lactate levels of the patients with mortality were found to be statistically significant higher than those without mortality (p = 0.001; p < 0.01). The cut off point for serum lactate level in predicting mortality was found to be ≥3.6 mmol/L. The mortality rate was found to be statistically significant higher in patients with serum lactate level 3,6 mmol/L and above (p = 0,001; p < 0,01).

Conclusion

In conclusion, we believe in the light of the findings of our study that the serum lactate level is effective and reliable in the prediction of mortality in patients who present to emergency department for any reason. However, prospective studies with broader patient groups are required in this subject.

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Keywords : Emergency department, Mortality, Morbidity, Lactat


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Vol 45

P. 495-500 - juillet 2021 Retour au numéro
Article précédent Article précédent
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