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.
DOI: 10.22514/SV151.042019.8 Vol.15,Issue 1,April 2019 pp.59-61
Published: 23 April 2019
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.
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