University of Health Sciences, Okmeydani Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey.
University of Health Sciences, Okmeydani Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey.
Am J Emerg Med. 2021 Jul;45:495-500. doi: 10.1016/j.ajem.2020.09.088. Epub 2020 Oct 5.
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.
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.
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).
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.
乳酸是一种易于测量的实验室参数，被认为是一种潜在有用的预后标志物，可用于确定急诊科患者的风险。本研究旨在探讨入院时血清乳酸在急诊科就诊患者中的作用。
本研究纳入了 2017 年 6 月至 2018 年 1 月期间因各种原因入住急诊科的患者。分析了患者的人口统计学数据、实验室检查结果、死亡率和住院率。主要终点为血清乳酸在预测死亡率中的作用，次要终点为预测住院率。
在 1382 名患者中，47.4%（n=655）为女性，52.6%（n=727）为男性。患者的平均年龄为 60.99±20.04 岁（18-100 岁）。在 59.6%（n=824）的患者中，最常见的合并疾病是高血压（36%）。有 43 名（3.1%）患者死亡。有 20.5%（n=284）的患者住院。有住院和死亡的患者的年龄明显高于没有住院和没有死亡的患者（p=0.001；p<0.01）。根据住院情况，患者的血清乳酸测量值之间无统计学显著差异（p>0.05）。有死亡的患者的血清乳酸水平明显高于没有死亡的患者（p=0.001；p<0.01）。预测死亡率的血清乳酸水平截断值为≥3.6mmol/L。血清乳酸水平为 3.6mmol/L 及以上的患者的死亡率明显更高（p=0.001；p<0.01）。
总之，根据我们的研究结果，我们认为血清乳酸水平在预测因任何原因就诊于急诊科的患者的死亡率方面是有效和可靠的。然而，在这一主题中需要进行具有更广泛患者群体的前瞻性研究。
