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Prognostic value of lactate in prehospital care as a predictor of mortality and high-risk patients with trauma
1Advanced Medical Life Support Valladolid I, Prehospital Emergency Medical Services, SACYL. Valladolid. Spain
2 Emergency Department. Hospital Universitario Rio Hortega, SACYL. Valladolid. Spain
3,Advanced Clinical Simulation Center. Faculty of Medicine. Valladolid University. Valladolid. Spain.
*Corresponding Author(s): RAÚL LÓPEZ-IZQUIERDO E-mail: rlopeziz@saludcastillayleon.es
Objectives. Major injury is a time-depend-ent illness in which the quantification of the life prognosis is fundamental for pro-fessionals. The objective of this study is to evaluate the capacity of prehospital lactic acid to predict mortality (2, 7 and 30 days) and the admission to the Intensive Care Unit (ICU) from the index event. Methods. This is a longitudinal, prospec-tive observational study, which included patients who were treated by an Advanced Life Support Unit and transferred to the Emergency Department between April 1 and September 30, 2018. We calculated sensitivity, specificity, and likelihood ra-tios. The main outcome variable was mor-tality from any cause (2, 7 and 30 days) and admission to ICU.
Results. 109 patients were included in our study. Eleven patients (10%) experienced early mortality before the first 48 hours af-ter the index event, with an ICU admission rate of 28%. The sensitivity and specificity of the test to determine mortality in less than two days was 63.6% (95% CI, 35.4-84.8%) and 87.8% (95% CI, 79.8-92.9%). Conclusions. Prehospital lactic acid has an excellent capacity to predict the mortality and the admission of patients with major injury to the ICU, and it is a cheap, easy-to-obtain and reliable diagnostic tool that can help in clinical decision-making.
Critical care; emergency depart-ment; outcome; survival; intensive care
FRANCISCO MARTÍN-RODRÍGUEZ,RAÚL LÓPEZ-IZQUIERDO. Prognostic value of lactate in prehospital care as a predictor of mortality and high-risk patients with trauma. Signa Vitae. 2019. 15(1);59-61.
1. Alberdi F, García I, Atutxa L, Zabarte M. Epidemiology of severe trauma. Med Intensiva 2014; 38(9): p. 580-8.
2. Stoll D, Englund E, Hillborg H, Vedin S, Larsson A. Capillary and venous lactate measurements with a handheld device compared to venous blood-gas analysis for emergency patients. Scand J Trauma Resusc Emerg Med 2018; 5(26): p. 47.
3. Lewis CT, Naumann DN, Crombie N, Midwinter MJ. Prehospital point-of-care lactate following trauma: A systematic review. J Trauma Acute Care Surg 2016; 81(4): p. 748-55.
4. Raux M, Le Manach Y, Gauss T, Baumgarten R, Hamada S, Harrois A, et al. Comparison of the Prognostic Significance of Initial Blood Lactate and Base Deficit in Trauma Patients. Anesthesiology 2017; 126(3): p. 522-33.
5. Brown JB, Lerner EB, Sperry JL, Billiar TR, Peitzman AB, Guyette FX. Prehospital Lactate Improves Accuracy of Prehospital Criteria for Designating Trauma Activation Level. J Trauma Acute Care Surg 2016; 81(3): p. 445-52.
6. Tobias AZ, Guyette FX, Seymour CW, Suffoletto BP, Martin-Gill C, Quintero J, et al. Pre-resuscitation lactate and hospital mortality in prehospital patients. Prehosp Emerg Care 2014; 18(3): p. 321-7.
7. Parsikia A, Bones K, Kaplan M, Strain J, Leung PS, Ortiz J, et al. The predictive value of initial serum lactate in trauma patients. Shock 2014; 42(3): p. 199-204.
8. Baxter J. Do lactate levels in the emergency department predict outcome in adult trauma patients? A systematic review. J Trauma Acute Care Surg 2016; 81(3): p. 555-66.
9. Lewis CT, Naumann DN, Crombie N, Midwinter MJ. Prehospital point-of-care lactate following trauma: A systematic review. J Trauma Acute Care Surg 2016; 81(4): p. 748-55.
10. Martín-Rodríguez F, López-Izquierdo R, Castro-Villamor MÁ, Moro-Mangas I, delBrio-Ibañez P, Delgado-Benito JF, et al. Prog-nostic value of lactate in prehospital care as a predictor of early mortality. Am J Emerg Med 2018; https://doi.org/10.1016/j. ajem.2018.11.028.
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