Prognostic Value of Blood Lactate for Mortality of Acutely Poisoned Patients in Emergency Department.
- Author:
Hye Ran KIM
1
;
Mun Ju KANG
;
Yong Hwan KIM
;
Jun Ho LEE
;
Kwang Won CHO
;
Seong Youn HWANG
;
Dong Woo LEE
Author Information
1. Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University, School of Medicine, Changwon, Korea. calmriver@daum.net
- Publication Type:Original Article
- Keywords:
Acute poisoning;
Lactate;
Mortality
- MeSH:
Area Under Curve;
Aspartate Aminotransferases;
Creatinine;
Critical Illness;
Demography;
Emergencies*;
Emergency Service, Hospital*;
Glasgow Coma Scale;
Hematologic Tests;
Humans;
Hyperlactatemia;
Lactic Acid*;
Logistic Models;
Mortality*;
Odds Ratio;
Poisoning;
Prognosis;
Retrospective Studies;
ROC Curve;
Sepsis;
Survivors
- From:Journal of The Korean Society of Clinical Toxicology
2016;14(1):16-25
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Patients suffering from acute poisoning by different substances often visit the emergency department (ED) and receive various prognoses according to the toxic material and patients' condition. Hyperlactatemia, which is an increased blood lactate level that generally indicates tissue hypoperfusion, is commonly utilized as a prognostic marker in critically ill patients such as those with sepsis. This study was conducted to investigate the relationships between blood lactate and clinical prognosis in acute poisoned patients. METHODS: This retrospective study was conducted from January 2013 to June 2014 at a single and regional-tertiary ED. We enrolled study patients who were examined for blood test with lactate among acute intoxicated patients. The toxic materials, patient demographics, laboratory data, and mortalities were also reviewed. Additionally, we analyzed variables including blood lactate to verify the correlation with patient mortality. RESULTS: A total of 531 patients were enrolled, including 24 (4.5%) non-survivors. Patient age, Glasgow coma scale (GCS), serum creatinine (Cr), aspartate transaminase (AST), and serum lactate differed significantly between survivors and non-survivors in the binary logistic regression analysis. Among these variables, GCS, AST, and lactate differed significantly. The median serum lactate levels were 2.0 mmol/L among survivors and 6.9 mmol/L among non-survivors. The AUC with the ROC curve and odds ratio of the initial serum lactate were 0.881 and 3.06 (0.89-8.64), respectively. CONCLUSION: Serum lactate was correlated with fatalities of acute poisoning patients in the ED; therefore, it may be used as a clinical predictor to anticipate their prognoses.
