The usefulness of lactate as an early predictor of the severity of emergency department patients with postpartum hemorrhage
- Author:
Young Joon CHO
1
;
Je Sung YOU
;
Sung Phil CHUNG
;
Minhong CHOA
;
Taeyoung KONG
;
Dong Ryul KO
;
Yoon Jung HWANG
;
Yong Hee LEE
;
Incheol PARK
;
Sinae KIM
Author Information
1. Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea. grampian@yuhs.ac
- Publication Type:Original Article
- Keywords:
Postpartum hemorrhage;
Prognosis;
Lactic acid
- MeSH:
Adult;
Cohort Studies;
Critical Pathways;
Emergencies;
Emergency Service, Hospital;
Hemorrhage;
Humans;
Hysterectomy;
Lactic Acid;
Postpartum Hemorrhage;
Postpartum Period;
Prognosis;
Prospective Studies;
Retrospective Studies
- From:Journal of the Korean Society of Emergency Medicine
2019;30(1):33-43
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: Only a few studies have examined the role of lactate reflecting on tissue hypoperfusion determining the severity of postpartum hemorrhage (PPH) patients in the emergency department (ED). This study evaluated the utility of the arterial lactate level as a prognostic marker of severity in PPH patients admitted to an ED. METHODS: This retrospective, observational cohort study was conducted on patients integrated prospectively in a critical pathway of SPEED (Severance Protocol to save postpartum bleeding through Expeditious care Delivery). Adult primary PPH patients admitted to the ED between July 1, 2010 and March 31, 2017 were analyzed. The outcomes were the development of severe PPH including death, hysterectomy, surgical treatment, and massive transfusion. RESULTS: A total of 112 patients were enrolled in this study. An increase in the arterial lactate value was a strong independent predictor of severe PPH. The increasing predictability of severe PPH was closely associated with an arterial lactate ≥3.15 mL/L at admission (odds ratio, 13.870; P < 0.001). CONCLUSION: Lactate is an independent predictor of severe PPH and is suitable for a rapid and simple estimation of the severity of PPH. Emergency physicians can use lactate to determine the initial treatment strategies more precisely.
