Prognostic value of incremental lactate elevations in emergency department patients with suspected infection

Michael A. Puskarich, Jeffrey Kline, Richard L. Summers, Alan E. Jones

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objectives: Previous studies have confirmed the prognostic significance of lactate concentrations categorized into groups (low, intermediate, high) among emergency department (ED) patients with suspected infection. Although the relationship between lactate concentrations categorized into groups and mortality appears to be linear, the relationship between lactate as a continuous measurement and mortality is uncertain. This study sought to evaluate the association between blood lactate concentrations along an incremental continuum up to a maximum value of 20 mmol/L and mortality. Methods: This was a retrospective cohort analysis of adult ED patients with suspected infection from a large urban ED during 2007-2010. Inclusion criteria were suspected infection evidenced by administration of antibiotics in the ED and measurement of whole blood lactate in the ED. The primary outcome was in-hospital mortality. Logistic and polynomial regression were used to model the relationship between lactate concentration and mortality. Results: A total of 2,596 patients met inclusion criteria and were analyzed. The initial median lactate concentration was 2.1 mmol/L (interquartile range [IQR] = 1.3 to 3.3 mmol/L) and the overall mortality rate was 14.4%. In the cohort, 459 patients (17.6%) had initial lactate levels >4 mmol/L. Mortality continued to rise across the continuum of incremental elevations, from 6% for lactate

Original languageEnglish (US)
Pages (from-to)983-985
Number of pages3
JournalAcademic Emergency Medicine
Volume19
Issue number8
DOIs
StatePublished - Aug 2012
Externally publishedYes

Fingerprint

Hospital Emergency Service
Lactic Acid
Infection
Mortality
Hospital Mortality
Cohort Studies
Logistic Models
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Prognostic value of incremental lactate elevations in emergency department patients with suspected infection. / Puskarich, Michael A.; Kline, Jeffrey; Summers, Richard L.; Jones, Alan E.

In: Academic Emergency Medicine, Vol. 19, No. 8, 08.2012, p. 983-985.

Research output: Contribution to journalArticle

Puskarich, Michael A. ; Kline, Jeffrey ; Summers, Richard L. ; Jones, Alan E. / Prognostic value of incremental lactate elevations in emergency department patients with suspected infection. In: Academic Emergency Medicine. 2012 ; Vol. 19, No. 8. pp. 983-985.
@article{86ea37c163d64d758cde3a4259d6e788,
title = "Prognostic value of incremental lactate elevations in emergency department patients with suspected infection",
abstract = "Objectives: Previous studies have confirmed the prognostic significance of lactate concentrations categorized into groups (low, intermediate, high) among emergency department (ED) patients with suspected infection. Although the relationship between lactate concentrations categorized into groups and mortality appears to be linear, the relationship between lactate as a continuous measurement and mortality is uncertain. This study sought to evaluate the association between blood lactate concentrations along an incremental continuum up to a maximum value of 20 mmol/L and mortality. Methods: This was a retrospective cohort analysis of adult ED patients with suspected infection from a large urban ED during 2007-2010. Inclusion criteria were suspected infection evidenced by administration of antibiotics in the ED and measurement of whole blood lactate in the ED. The primary outcome was in-hospital mortality. Logistic and polynomial regression were used to model the relationship between lactate concentration and mortality. Results: A total of 2,596 patients met inclusion criteria and were analyzed. The initial median lactate concentration was 2.1 mmol/L (interquartile range [IQR] = 1.3 to 3.3 mmol/L) and the overall mortality rate was 14.4{\%}. In the cohort, 459 patients (17.6{\%}) had initial lactate levels >4 mmol/L. Mortality continued to rise across the continuum of incremental elevations, from 6{\%} for lactate",
author = "Puskarich, {Michael A.} and Jeffrey Kline and Summers, {Richard L.} and Jones, {Alan E.}",
year = "2012",
month = "8",
doi = "10.1111/j.1553-2712.2012.01404.x",
language = "English (US)",
volume = "19",
pages = "983--985",
journal = "Academic Emergency Medicine",
issn = "1069-6563",
publisher = "Wiley-Blackwell",
number = "8",

}

TY - JOUR

T1 - Prognostic value of incremental lactate elevations in emergency department patients with suspected infection

AU - Puskarich, Michael A.

AU - Kline, Jeffrey

AU - Summers, Richard L.

AU - Jones, Alan E.

PY - 2012/8

Y1 - 2012/8

N2 - Objectives: Previous studies have confirmed the prognostic significance of lactate concentrations categorized into groups (low, intermediate, high) among emergency department (ED) patients with suspected infection. Although the relationship between lactate concentrations categorized into groups and mortality appears to be linear, the relationship between lactate as a continuous measurement and mortality is uncertain. This study sought to evaluate the association between blood lactate concentrations along an incremental continuum up to a maximum value of 20 mmol/L and mortality. Methods: This was a retrospective cohort analysis of adult ED patients with suspected infection from a large urban ED during 2007-2010. Inclusion criteria were suspected infection evidenced by administration of antibiotics in the ED and measurement of whole blood lactate in the ED. The primary outcome was in-hospital mortality. Logistic and polynomial regression were used to model the relationship between lactate concentration and mortality. Results: A total of 2,596 patients met inclusion criteria and were analyzed. The initial median lactate concentration was 2.1 mmol/L (interquartile range [IQR] = 1.3 to 3.3 mmol/L) and the overall mortality rate was 14.4%. In the cohort, 459 patients (17.6%) had initial lactate levels >4 mmol/L. Mortality continued to rise across the continuum of incremental elevations, from 6% for lactate

AB - Objectives: Previous studies have confirmed the prognostic significance of lactate concentrations categorized into groups (low, intermediate, high) among emergency department (ED) patients with suspected infection. Although the relationship between lactate concentrations categorized into groups and mortality appears to be linear, the relationship between lactate as a continuous measurement and mortality is uncertain. This study sought to evaluate the association between blood lactate concentrations along an incremental continuum up to a maximum value of 20 mmol/L and mortality. Methods: This was a retrospective cohort analysis of adult ED patients with suspected infection from a large urban ED during 2007-2010. Inclusion criteria were suspected infection evidenced by administration of antibiotics in the ED and measurement of whole blood lactate in the ED. The primary outcome was in-hospital mortality. Logistic and polynomial regression were used to model the relationship between lactate concentration and mortality. Results: A total of 2,596 patients met inclusion criteria and were analyzed. The initial median lactate concentration was 2.1 mmol/L (interquartile range [IQR] = 1.3 to 3.3 mmol/L) and the overall mortality rate was 14.4%. In the cohort, 459 patients (17.6%) had initial lactate levels >4 mmol/L. Mortality continued to rise across the continuum of incremental elevations, from 6% for lactate

UR - http://www.scopus.com/inward/record.url?scp=84865356555&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84865356555&partnerID=8YFLogxK

U2 - 10.1111/j.1553-2712.2012.01404.x

DO - 10.1111/j.1553-2712.2012.01404.x

M3 - Article

VL - 19

SP - 983

EP - 985

JO - Academic Emergency Medicine

JF - Academic Emergency Medicine

SN - 1069-6563

IS - 8

ER -