Department of Translational Medicine, St. Anna University Hospital of Ferrara, University of Ferrara, 44124 Ferrara, Italy.
Emergency Department, St. Anna University Hospital of Ferrara, 44124 Ferrara, Italy.
Int J Mol Sci. 2023 May 23;24(11):9121. doi: 10.3390/ijms24119121.
Sepsis is a time-dependent and life-threating condition related to macro- and micro-circulatory impairment leading to anaerobic metabolism and lactate increase. We assessed the prognostic accuracy of capillary lactates (CLs) vs. serum ones (SLs) on 48-h and 7-day mortality in patients with suspected sepsis. This observational, prospective, single-centre study was conducted between October 2021 and May 2022. Inclusion criteria were: (i) suspect of infection; (ii) qSOFA ≥ 2; (iii) age ≥ 18 years; (iv) signed informed consent. CLs were assessed with LactateProTM2. 203 patients were included: 19 (9.3%) died within 48 h from admission to the Emergency Department, while 28 (13.8%) within 7 days. Patients deceased within 48 h (vs. survived) had higher CLs (19.3 vs. 5 mmol/L, < 0.001) and SLs (6.5 vs. 1.1 mmol/L, = 0.001). The best CLs predictive cut-off for 48-h mortality was 16.8 mmol/L (72.22% sensitivity, 94.02% specificity). Patients within 7 days had higher CLs (11.5 vs. 5 mmol/L, = 0.020) than SLs (2.75 vs. 1.1 mmol/L, < 0.001). The multivariate analysis confirmed CLs and SLs as independent predictors of 48-h and 7-day mortality. CLs can be a reliable tool for their inexpensiveness, rapidity and reliability in identifying septic patients at high risk of short-term mortality.
脓毒症是一种与宏观和微观循环损伤相关的、危及生命的、时间依赖性疾病，可导致无氧代谢和乳酸增加。我们评估了毛细血管乳酸（CLs）与血清乳酸（SLs）在疑似脓毒症患者 48 小时和 7 天死亡率中的预后准确性。这项观察性、前瞻性、单中心研究于 2021 年 10 月至 2022 年 5 月进行。纳入标准为：（i）疑似感染；（ii）qSOFA ≥ 2；（iii）年龄≥18 岁；（iv）签署知情同意书。CLs 使用 LactateProTM2 进行评估。共纳入 203 例患者：19 例（9.3%）在急诊科就诊后 48 小时内死亡，28 例（13.8%）在 7 天内死亡。48 小时内死亡（vs. 存活）的患者 CLs（19.3 vs. 5 mmol/L，< 0.001）和 SLs（6.5 vs. 1.1 mmol/L，= 0.001）更高。预测 48 小时死亡率的最佳 CLs 截断值为 16.8 mmol/L（72.22%的敏感性，94.02%的特异性）。7 天内的患者 CLs（11.5 vs. 5 mmol/L，= 0.020）高于 SLs（2.75 vs. 1.1 mmol/L，< 0.001）。多变量分析证实 CLs 和 SLs 是 48 小时和 7 天死亡率的独立预测因素。CLs 可以作为一种廉价、快速和可靠的工具，用于识别短期死亡率高的脓毒症患者。
