scholarly journals Anemia and high hematocrit are associated with in-hospital mortality in emergency department patients with suspected infection

Critical Care ◽  
2014 ◽  
Vol 18 (Suppl 1) ◽  
pp. P108
Author(s):  
M Jessen ◽  
S Skibsted ◽  
N Shapiro
Keyword(s):  
Emergency Department ◽  
Hospital Mortality ◽  
Suspected Infection ◽  
Emergency Department Patients

scholarly journals The Feasibility and Accuracy of Point-of-Care Lactate Measurement in Emergency Department Patients with Suspected Infection

2010 ◽  
Vol 39 (1) ◽  
pp. 89-94 ◽  
Author(s):  
Nathan I. Shapiro ◽  
Christopher Fisher ◽  
Michael Donnino ◽  
Lauren Cataldo ◽  
Aimee Tang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Point Of Care ◽  
Suspected Infection ◽  
Lactate Measurement ◽  
Emergency Department Patients

The Association of Sepsis Syndrome and Organ Dysfunction With Mortality in Emergency Department Patients With Suspected Infection

2006 ◽  
Vol 48 (5) ◽  
pp. 583-590.e1 ◽  
Author(s):  
Nathan Shapiro ◽  
Michael D. Howell ◽  
David W. Bates ◽  
Derek C. Angus ◽  
Long Ngo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Organ Dysfunction ◽  
Sepsis Syndrome ◽  
Suspected Infection ◽  
Emergency Department Patients

scholarly journals Relative Hyperlactatemia in the Emergency Department: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Ralphe Bou Chebl ◽  
Sarah Jamali ◽  
Nancy Mikati ◽  
Reem Al Assaad ◽  
Karim Abdel Daem ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hospital Mortality ◽  
Lactate Level ◽  
Reference Range ◽  
Serum Lactate ◽  
Optimal Cutoff ◽  
The Mean ◽  
Emergency Department Patients ◽  
Lactate Levels ◽  
Youden’S Index

Abstract Objective The clinical interpretation of lactate ≤ 2.00 mmol/L in emergency department (ED) patients is not well characterized. This study aims to determine the optimal cutoff value for lactate within the reference range that predicts in-hospital mortality among ED patients with initial serum lactate levels within the reference range. Methods This was a retrospective study of adult patients presenting to a tertiary ED between the dates of January 1, 2014 and June 30, 2019 with an initial serum lactate level less than 2.00 mmol/L. The primary outcome was in-hospital mortality. Youden’s index was utilized to determine the optimal threshold that predicts mortality. Patients above the threshold were labeled as having relative hyperlactatemia. A multivariate logistic regression was performed to determine the association between relative hyperlactatemia and in-hospital mortality. Subgroup analyses were done to further examine the interaction between relative hyperlactatemia and hospital mortality. Results During the study period, 1638 patients were included. The mean age was 66.9 ± 18.6 years, 47.1% of the population were female, and the most prevalent comorbidity was hypertension (56.7%). The mean lactate level at presentation was 1.5 ± 0.3 mmol/L. In-hospital mortality was 3.8% in the overall population and 16.2% were admitted to the ICU. A lactate of 1.33 mmol/L was found to be the optimal cutoff that best discriminates between survivors and non-survivors. Relative hyperlactatemia was an independent predictor of in-hospital mortality (OR 1.78 CI1.18-4.03; p 0.02). Finally, Relative hyperlactatemia was associated with increased mortality in patients without hypertension (4.7% versus 1.1%; p 0.008), as well as patients without diabetes or COPD. Conclusion The optimal cutoff of initial serum lactate that discriminates between survivors and non-survivors is in the ED 1.33 mmol/L. Relative hyperlactatemia is associated with increased mortality in emergency department patients, and this interaction seems to be more important in healthy patients.

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