Webb Amanda L, Kramer Nicholas, Rosario Javier, Dub Larissa, Lebowitz David, Amico Kendra, Leon Leoh, Stead Tej G, Vera Ariel, Ganti Latha
Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA.
Emergency Medicine, Brown University, Providence, USA.
Cureus. 2020 Apr 27;12(4):e7863. doi: 10.7759/cureus.7863.
This study examines the relationship between serial serum lactate levels and in-hospital mortality in an adult cohort of emergency department patients with severe sepsis or septic shock. Of the 164 patients in the cohort, 130 also got three-hour lactate in addition to the initial one. The median initial lactate was 3.01 (interquartile range [IQR]: 1.71-4.62). The median repeat lactate was 2.58 (IQR: 1.4-3.9). The in-hospital death rate was 23% for men and 29% for women. The delta lactate was significantly higher in women (P=0.0070), driven by a lower initial lactate (P=0.0277). In a multivariate regression model controlled for age and gender, a statistically significant correlation was noted between an increase in the delta lactate and in-hospital death (P=0.0323; R=11.3%). The results of this single-center study suggest that an increase in serum lactic acid is significantly associated with higher in-hospital death.
本研究调查了成年急诊科严重脓毒症或脓毒性休克患者系列血清乳酸水平与院内死亡率之间的关系。该队列中的164例患者中，130例除首次检测乳酸外，还进行了3小时后的乳酸检测。首次乳酸水平中位数为3.01（四分位间距[IQR]：1.71 - 4.62）。重复检测乳酸水平中位数为2.58（IQR：1.4 - 3.9）。男性院内死亡率为23%，女性为29%。女性的乳酸变化值显著更高（P = 0.0070），这是由较低的首次乳酸水平导致的（P = 0.0277）。在一个控制了年龄和性别的多变量回归模型中，乳酸变化值增加与院内死亡之间存在统计学显著相关性（P = 0.0323；R = 11.3%）。这项单中心研究结果表明，血清乳酸水平升高与更高的院内死亡率显著相关。
