The prognostic value of blood lactate levels relative to that of vital signs in the pre-hospital setting: a pilot study
2008

Blood Lactate Levels and In-Hospital Mortality

Sample size: 124 publication Evidence: moderate

Author Information

Author(s): Tim C Jansen, Jasper van Bommel, Paul G Mulder, Johannes H Rommes, Selma JM Schieveld, Jan Bakker

Primary Institution: Erasmus MC University Medical Center

Hypothesis

Pre-hospital blood lactate measurements would enable the prediction of in-hospital mortality independent of standard vital parameters.

Conclusion

Pre-hospital blood lactate levels were associated with in-hospital mortality and provided better prognostic information than vital signs.

Supporting Evidence

  • Non-survivors had significantly higher lactate levels than survivors.
  • A lactate level of 3.5 mmol/L was the best cut-off for predicting mortality.
  • Mortality was higher in patients with lactate levels of 3.5 mmol/L or higher.
  • Delta lactate level was an independent predictor of in-hospital mortality.
  • Pre-hospital lactate levels provided prognostic information superior to vital signs.

Takeaway

Doctors can check blood lactate levels in patients before they reach the hospital to see if they might be in danger of dying.

Methodology

This was a prospective observational study where blood lactate levels were measured in patients requiring urgent ambulance dispatching.

Potential Biases

The study's design may have introduced bias by selecting patients based on vital sign abnormalities.

Limitations

The study was conducted in 1997-1998, and the data may not reflect current practices; also, it included only patients with abnormal vital signs.

Participant Demographics

The mean age of participants was 62 years, with 59% male.

Statistical Information

P-Value

0.018

Confidence Interval

0.05 to 0.76

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/cc7159

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