دورية أكاديمية
Emergency department lactate is associated with mortality in older adults admitted with and without infections.
| العنوان: | Emergency department lactate is associated with mortality in older adults admitted with and without infections. |
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| المؤلفون: | del Portal DA; University of Pennsylvania School of Medicine, Department of Emergency Medicine, Philadelphia, PA, USA., Shofer F, Mikkelsen ME, Dorsey PJ Jr, Gaieski DF, Goyal M, Synnestvedt M, Weiner MG, Pines JM |
| المصدر: | Academic emergency medicine : official journal of the Society for Academic Emergency Medicine [Acad Emerg Med] 2010 Mar; Vol. 17 (3), pp. 260-8. |
| نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley Country of Publication: United States NLM ID: 9418450 Publication Model: Print Cited Medium: Internet ISSN: 1553-2712 (Electronic) Linking ISSN: 10696563 NLM ISO Abbreviation: Acad Emerg Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Hoboken, N.J. : Wiley Original Publication: Philadelphia, PA : Hanley & Belfus, c1993- |
| مواضيع طبية MeSH: | Hospital Mortality* , Infections*/blood , Infections*/mortality, Emergency Service, Hospital/*statistics & numerical data , Lactic Acid/*blood , Patient Admission/*statistics & numerical data, Aged ; Aged, 80 and over ; Biomarkers/blood ; Chi-Square Distribution ; Creatinine/blood ; Critical Illness/mortality ; Female ; Hospitals, Teaching ; Hospitals, Urban ; Humans ; Leukocyte Count ; Male ; Pennsylvania/epidemiology ; Predictive Value of Tests ; ROC Curve ; Regression Analysis ; Retrospective Studies ; Selection Bias ; Single-Blind Method |
| مستخلص: | Objectives: Serum lactate values in the emergency department (ED) have been associated with mortality in diverse populations of critically ill patients. This study investigates whether serum lactate values measured in the ED are associated with mortality in older patients admitted to the hospital, both with and without infections. Methods: This is a retrospective cohort study performed at two urban teaching hospitals. The study population includes 1,655 older ED patients (age>or=65 years) over a 3-year period (2004-2006) who had serum lactate measured prior to admission. The presence or absence of infection was determined by review of International Classification of Diseases Ninth Revision (ICD-9) admission diagnosis codes. Mortality during hospitalization was determined by review of inpatient records. Mortality at 30 and at 60 days was determined using a state death registry. Results: In patients with infections, increasing serum lactate values of >or=2.0 mmol/L were linearly associated with relative risk (RR) of mortality during hospitalization (RR=1.9 to 3.6 with increasing lactate), at 30 days (RR=1.7 to 2.6), and at 60 days (RR=1.4 to 2.3) when compared to patients with serum lactate levels of <2.0 mmol/L. In patients without infections, a similar association was observed (RR=1.1 to 3.9 during hospitalization, RR=1.2 to 2.6 at 30 days, RR=1.1 to 2.4 at 60 days). In both groups of patients, serum lactate had a greater magnitude of association with mortality than either of two other commonly ordered laboratory tests, leukocyte count and serum creatinine. Conclusions: Higher ED lactate values are associated with greater mortality in a broad cohort of admitted patients over age 65 years, regardless of the presence or absence of infection. (Copyright (c) 2010 by the Society for Academic Emergency Medicine.) |
| المشرفين على المادة: | 0 (Biomarkers) 33X04XA5AT (Lactic Acid) AYI8EX34EU (Creatinine) |
| تواريخ الأحداث: | Date Created: 20100408 Date Completed: 20100708 Latest Revision: 20220408 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1111/j.1553-2712.2010.00681.x |
| PMID: | 20370758 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1553-2712 |
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| DOI: | 10.1111/j.1553-2712.2010.00681.x |