High Plasma Lactate Levels Are Associated With Increased Risk of In-hospital Mortality in Patients With Pulmonary Embolism.
Acad Emerg Med. 2011 Aug;18(8):830-5
Authors: Vanni S, Socci F, Pepe G, Nazerian P, Viviani G, Baioni M, Conti A, Grifoni S
ACADEMIC EMERGENCY MEDICINE 2011; 18:830-835 © 2011 by the Society for Academic Emergency Medicine ABSTRACT: Objectives:? The objective was to investigate the prognostic value of plasma lactate in patients with acute pulmonary embolism (PE). Methods:? This was a retrospective study at the emergency department (ED) of a third-level teaching hospital. The authors considered consecutive patients with a diagnosis of PE established by lung scan or spiral computed tomography (CT) and confirmed by pulmonary angiography if necessary. Only patients for whom plasma lactate levels had been tested within 6?hours from presentation to the ED were included. Primary outcome was in-hospital death due to any cause; secondary outcome was mortality related to PE. Results:? From September 1997 to June 2006, a total of 384 patients were diagnosed with PE in the ED. Of these patients, 287 had registered plasma lactate levels and were included in this analysis. Included patients had a mean age of 70 (SD?±?15?years, range?=?18 to 100?years), 163 (57%) were female, 26 (9%) showed systolic blood pressure lower than 100?mm?Hg at presentation, and 160 (56%) had echocardiographic evidence of right ventricular dysfunction (RVD). Twenty patients died during their hospital stay (7%). Plasma lactate levels ? 2?mmol/L were associated with in-hospital mortality from all causes (odds ratio [OR]?=?4.60, 95% confidence interval [CI]?=?1.57 to 13.53) and with PE-related mortality (OR?=?4.94, 95% CI?=?1.38 to 17.63), independent of hypotension or RVD at presentation. Conclusions:? High plasma lactate was associated with increased in-hospital mortality in this sample of patients with acute PE.
PMID: 21843218 [PubMed - in process]