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Lactate measurements accurately predicts 1-week mortality in emergency department patients with acute kidney injury

BACKGROUND: Studies on prognostic indicators in patients with acute kidney injury are limited. This study investigated 1-week mortality, laboratory and clinical parameters according to the lactate levels in patients with acute kidney injury. METHODS: In this cross-sectional study, we compared the la...

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Autores principales: Aliustaoglu Bayar, Ayse Elif, Aksay, Ersin, Oray, Nese Colak
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6819718/
https://www.ncbi.nlm.nih.gov/pubmed/31687612
http://dx.doi.org/10.1016/j.tjem.2019.08.002
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author Aliustaoglu Bayar, Ayse Elif
Aksay, Ersin
Oray, Nese Colak
author_facet Aliustaoglu Bayar, Ayse Elif
Aksay, Ersin
Oray, Nese Colak
author_sort Aliustaoglu Bayar, Ayse Elif
collection PubMed
description BACKGROUND: Studies on prognostic indicators in patients with acute kidney injury are limited. This study investigated 1-week mortality, laboratory and clinical parameters according to the lactate levels in patients with acute kidney injury. METHODS: In this cross-sectional study, we compared the lactate levels on admission and follow-up in emergency department with vital findings, laboratory parameters, and 1-week mortality. RESULTS: Data of 3375 patients examined; 2681 patients excluded and 694 patients were included. Median lactate level on admission was 1.6 (1.1–2.5) mmol/L for patients who discharged from emergency department, 2.2 (1.3–3.4) mmol/L for patients admitted to the hospital wards, 3.7 (1.7–7.2) mmol/L for patients admitted to the intensive care unit and 4.4 (2.4–8.0) mmol/L for patients with mortality within 1-week of ED presentation. Mortality was 30.4% in patients with high lactate levels and 8.1% in patients with normal lactate levels on admission. (p < 0.001, odds ratio 5.0, 95% CI 3.2–7.7) Elevated lactate level was independent risk factor for 1-week-mortality. (p < 0.001, odds ratio 1.138, 95% CI 1.067–1.214) Patients with high lactate levels have low systolic blood pressure, diastolic blood pressure, oxygen saturation, pH, base deficit, and bicarbonate, and higher heart rate and respiratory rate. The mortality of patients with normal lactate levels on admission was 8.1%, while mortality rate increased to 19% if elevated lactate levels observed during emergency department follow-up. CONCLUSIONS: Elevated lactate level predicts 1-week mortality in patients presenting with acute kidney injury in emergency department. Elevated lactate level were associated with poorer vital signs and abnormal laboratory results.
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spelling pubmed-68197182019-11-04 Lactate measurements accurately predicts 1-week mortality in emergency department patients with acute kidney injury Aliustaoglu Bayar, Ayse Elif Aksay, Ersin Oray, Nese Colak Turk J Emerg Med Original Research Paper BACKGROUND: Studies on prognostic indicators in patients with acute kidney injury are limited. This study investigated 1-week mortality, laboratory and clinical parameters according to the lactate levels in patients with acute kidney injury. METHODS: In this cross-sectional study, we compared the lactate levels on admission and follow-up in emergency department with vital findings, laboratory parameters, and 1-week mortality. RESULTS: Data of 3375 patients examined; 2681 patients excluded and 694 patients were included. Median lactate level on admission was 1.6 (1.1–2.5) mmol/L for patients who discharged from emergency department, 2.2 (1.3–3.4) mmol/L for patients admitted to the hospital wards, 3.7 (1.7–7.2) mmol/L for patients admitted to the intensive care unit and 4.4 (2.4–8.0) mmol/L for patients with mortality within 1-week of ED presentation. Mortality was 30.4% in patients with high lactate levels and 8.1% in patients with normal lactate levels on admission. (p < 0.001, odds ratio 5.0, 95% CI 3.2–7.7) Elevated lactate level was independent risk factor for 1-week-mortality. (p < 0.001, odds ratio 1.138, 95% CI 1.067–1.214) Patients with high lactate levels have low systolic blood pressure, diastolic blood pressure, oxygen saturation, pH, base deficit, and bicarbonate, and higher heart rate and respiratory rate. The mortality of patients with normal lactate levels on admission was 8.1%, while mortality rate increased to 19% if elevated lactate levels observed during emergency department follow-up. CONCLUSIONS: Elevated lactate level predicts 1-week mortality in patients presenting with acute kidney injury in emergency department. Elevated lactate level were associated with poorer vital signs and abnormal laboratory results. Elsevier 2019-08-31 /pmc/articles/PMC6819718/ /pubmed/31687612 http://dx.doi.org/10.1016/j.tjem.2019.08.002 Text en 2019 Emergency Medicine Association of Turkey. Production and hosting by Elsevier B. V. on behalf of the Owner. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research Paper
Aliustaoglu Bayar, Ayse Elif
Aksay, Ersin
Oray, Nese Colak
Lactate measurements accurately predicts 1-week mortality in emergency department patients with acute kidney injury
title Lactate measurements accurately predicts 1-week mortality in emergency department patients with acute kidney injury
title_full Lactate measurements accurately predicts 1-week mortality in emergency department patients with acute kidney injury
title_fullStr Lactate measurements accurately predicts 1-week mortality in emergency department patients with acute kidney injury
title_full_unstemmed Lactate measurements accurately predicts 1-week mortality in emergency department patients with acute kidney injury
title_short Lactate measurements accurately predicts 1-week mortality in emergency department patients with acute kidney injury
title_sort lactate measurements accurately predicts 1-week mortality in emergency department patients with acute kidney injury
topic Original Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6819718/
https://www.ncbi.nlm.nih.gov/pubmed/31687612
http://dx.doi.org/10.1016/j.tjem.2019.08.002
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