Health Science University, T.R. Ministry of Health Basaksehir Cam and Sakura City Hospital, Department of Emergency Medicine, Istanbul, Turkey.
Health Sciences University, Kanuni Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey.
Ethiop J Health Sci. 2023 Mar;33(2):255-262. doi: 10.4314/ejhs.v33i2.10.
The aim of the present study was to detect the prognostic importance of lactate and other blood gas parameters for mortality prediction in patients with critical malignancies referring to the emergency service. The general condition of patients with malignancy who have referred to the emergency department should be evaluated and it should be shown that they are not in any oncological emergency. It is a highly significant predictor of mortality after sepsis and shock in hyperlactatemia accompanying metabolic acidosis. It is significantly used for treatment monitoring.
This study was planned prospective and observational study. The patients enrolled were divided into two groups including survivor and non-survivor depending on 30-day mortality. The primary outcome of the study was determined as following the mortality within 30 days.
The mean lactate level was 1.9 (1.4-2.5) mmol/L in the survivor group, and 2.6 (1.9-4.4) mmol/L in the non-survivor group; a significant difference was obtained between both groups (p<0.001). When the cut-off value of the lactate was determined as >2.95 mmol/L in order to differentiate the survivors from non-survivors, the sensitivity and specificity were detected as 35.0% and 86.1%, respectively. It was detected by the multivariate regression analysis that lactate predicts the 30-day mortality with a higher significance level in patients with critical malignancies.
It was concluded that lactate is a good predictor and may be used safely in predicting 30-day mortality in patients with any critical malignancy referring to the emergency department.
本研究旨在检测乳酸和其他血气参数对危急恶性肿瘤患者急诊死亡率的预后重要性。应评估患有恶性肿瘤的患者的一般状况，并表明他们没有任何肿瘤急症。在伴有代谢性酸中毒的高乳酸血症并发脓毒症和休克后，它是死亡率的高度重要预测因子。它被广泛用于治疗监测。
本研究计划为前瞻性观察性研究。根据 30 天死亡率，将入组患者分为存活组和非存活组。研究的主要结局为 30 天内的死亡率。
存活组的平均乳酸水平为 1.9（1.4-2.5）mmol/L，非存活组为 2.6（1.9-4.4）mmol/L；两组间差异有统计学意义（p<0.001）。当以乳酸>2.95mmol/L 作为区分存活者和非存活者的截断值时，灵敏度和特异性分别为 35.0%和 86.1%。多变量回归分析显示，乳酸对危急恶性肿瘤患者 30 天死亡率的预测具有更高的显著水平。
乳酸是一种良好的预测指标，可安全用于预测急诊任何危急恶性肿瘤患者的 30 天死亡率。
