High serum lactate level may predict death within 24 hours

• Authors: Arnon Blum , Abd Almajid Zoubi , Shiran Kuria , Nava Blum
• Languages of publication: EN

Abstracts

EN

Background: Unexpected death within 24 hours
of admission is a real challenge for the clinician in the
emergency room. How to diagnose these patients and the
right approach to prevent sudden death with 24 hours is
still an enigma. The aims of our study were to find the
independent factors that may affect the clinical outcome
in the first 24 hours of admission to the hospital. Methods: We performed a retrospective study defining
unexpected death within 24 hours of admission in our
Department of Medicine in the last 6 years. We found
43 patients who died within 24 hours of admission, and
compared their clinical and biochemical characteristics
to 6055 consecutive patients who were admitted in that
period of time and did not die within the first 24 hours of
admission. The parameters that were used include gender,
age, temperature, clinical and laboratory criteria for SIRS,
arterial blood lactate, and arterial blood pH. Results: Most of the patients who died within 24 hours
had sepsis with SIRS. These patients were older (78.6±14.7
vs. 65.2±20.2 years [p<.0001]), had higher lactate levels
(8.0±4.8 vs. 2.1±1.8mmol/L[p<.0001]), and lower pH
(7.2±0.2 vs. 7.4±0.1 [p<.0001]). Logistic regression analysis
found that lactate was the strongest independent parameter
to predict death within 24 hours of admission (OR1.366 [95% CI 1.235-1.512]), followed by old age (OR 1.048
[95% CI 1.048-1.075] and low arterial blood pH (OR 0.007
[CI <0.001-0.147]). When gender was analyzed, pH was not
an independent variable in females (only in males). Conclusions: The significant independent variable that
predicted death within 24 hours of admission was arterial
blood lactate level on admission. Older age was also
an independent variable; low pH affected only males,
but was a less dominant variable. We suggest use of arterial
blood lactate level on admission as a bio-marker in
patients with suspected sepsis admitted to the hospital for
risk assessment and prediction of death within 24 hours
of admission.

Keywords

EN

Lactate; SIRS

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2014
• Volume: 10
• Issue: 1

Dates

online

11 - 6 - 2015

accepted

21 - 5 - 2015

received

25 - 1 - 2015

Contributors

author

Arnon Blum

• Department of Medicine, Baruch
  Padeh Poria Hospital, Faculty of Medicine Bar Ilan University, Israel

author

Abd Almajid Zoubi

• Department of Medicine, Baruch
  Padeh Poria Hospital, Faculty of Medicine Bar Ilan University, Israel

author

Shiran Kuria

• Department of Medicine, Baruch
  Padeh Poria Hospital, Faculty of Medicine Bar Ilan University, Israel

author

Nava Blum

• Department of Health Systems Administration, Max
  Stern Academic College, Emek Yezreel, Lower Galilee 15208 Israel

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Identifiers

DOI

10.1515/med-2015-0045