Endocrinology, Prince of Wales Hospital, Barker St, Randwick, NSW, 2031, Australia.
Emergency Department, Prince of Wales Hospital, Randwick, NSW, Australia.
Acta Diabetol. 2021 Oct;58(10):1343-1349. doi: 10.1007/s00592-021-01725-7. Epub 2021 May 2.
Our aim was to determine the relationship between glucose and lactate amongst adult patients admitted to hospital via the emergency department.
We performed a cross-sectional observational study of 2541 patients admitted via the emergency department who had an admission glucose and lactate measurement available.
23% of the whole cohort had a diagnosis of diabetes. Glucose and lactate were predictors of the primary outcome of critical illness defined as composite of intensive care unit (ICU) admission or in-hospital death. In the multivariable analysis, lactate but not glucose remained an independent predictor of ICU/in hospital death in the group without diabetes. In the diabetes group, both glucose and lactate remained independent predictors of ICU admission/ in-hospital death.
Hyperglycaemia and hyperlactataemia are part of the metabolic response to critical illness. Lactate and a diagnosis of diabetes modify the relationship between glycaemia and critical illness.
我们旨在确定急诊收治的成年患者中血糖和乳酸之间的关系。
我们对 2541 名通过急诊收治且入院时血糖和乳酸检测结果均可用的患者进行了横断面观察性研究。
整个队列中有 23%的患者被诊断为糖尿病。血糖和乳酸是重症的预测因子，重症定义为综合重症监护病房（ICU）入院或住院期间死亡。在多变量分析中，在无糖尿病的患者中，乳酸而非血糖仍然是 ICU/院内死亡的独立预测因子。在糖尿病组中，血糖和乳酸均是 ICU 入住/院内死亡的独立预测因子。
高血糖和高乳酸血症是对重症的代谢反应的一部分。乳酸和糖尿病的诊断改变了血糖与重症之间的关系。
