The Predictive Role of Lactate in the Emergency Department in Patients with Severe Dyspnea
Objective. An accurate identification of patients at the need for prioritized diagnostics and care are crucial in the emergency department (ED). Blood gas (BG) analysis is a widely available laboratory test, which allows to measure vital parameters, including markers of ventilation and perfusion. Th...
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2024/6624423 |
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| author | Maciej Niczewski Szymon Gawęda Paulina Kluszczyk Mikołaj Rycerski Daria Syguła Anna Danel Szymon Szmigiel Konrad Mendrala Aleksandra Oraczewska Czarosław Kijonka Monika Nowicka Michał Wita Tomasz Cyzowski Grzegorz Brożek Maciej Dyrbuś Szymon Skoczyński |
| author_facet | Maciej Niczewski Szymon Gawęda Paulina Kluszczyk Mikołaj Rycerski Daria Syguła Anna Danel Szymon Szmigiel Konrad Mendrala Aleksandra Oraczewska Czarosław Kijonka Monika Nowicka Michał Wita Tomasz Cyzowski Grzegorz Brożek Maciej Dyrbuś Szymon Skoczyński |
| author_sort | Maciej Niczewski |
| collection | DOAJ |
| description | Objective. An accurate identification of patients at the need for prioritized diagnostics and care are crucial in the emergency department (ED). Blood gas (BG) analysis is a widely available laboratory test, which allows to measure vital parameters, including markers of ventilation and perfusion. The aim of our analysis was to assess whether blood gas parameters in patients with dyspnea at an increased risk of respiratory failure admitted to the ED can predict short-term outcomes. Methods. The study group eventually consisted of 108 patients, with available BG analysis. The clinical and laboratory parameters were retrospectively evaluated, and three groups were distinguished—arterial blood gas (ABG), venous blood gas (VBG), and mixed blood gas. The primary endpoint was short-term, all-cause mortality during the follow-up of median (quartile 1–quartile 3) 2 (1–4) months. The independent risk factors for mortality that could be obtained from blood gas sampling were evaluated. Results. The short-term mortality was 35.2% (38/108). Patients who died were more frequently initially assigned to the red triage risk group, more burdened with comorbidities, and the median SpO2 on admission was significantly lower than in patients who survived the follow-up period. In the multivariable analysis, lactate was the strongest independent predictor of death, with 1 mmol/L increasing all-cause mortality by 58% in ABG (95% CI: 1.01–2.47), by 80% in VBG (95% CI: 1.13–2.88), and by 68% in the mixed blood gas analysis (95% CI: 1.22–2.31), what remained significant in VBG and mixed group after correction for base excess. In each group, pH, pO2, and pCO2 did not predict short-term mortality. Conclusions. In patients admitted to the ED due to dyspnea, at risk of respiratory failure, lactate levels in arterial, venous, and mixed blood samples are independent predictors of short-term mortality. |
| format | Article |
| id | doaj-art-01837a6d0e31483e8cb9d18cd201e692 |
| institution | Kabale University |
| issn | 2090-2859 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-01837a6d0e31483e8cb9d18cd201e6922025-02-03T07:23:41ZengWileyEmergency Medicine International2090-28592024-01-01202410.1155/2024/6624423The Predictive Role of Lactate in the Emergency Department in Patients with Severe DyspneaMaciej Niczewski0Szymon Gawęda1Paulina Kluszczyk2Mikołaj Rycerski3Daria Syguła4Anna Danel5Szymon Szmigiel6Konrad Mendrala7Aleksandra Oraczewska8Czarosław Kijonka9Monika Nowicka10Michał Wita11Tomasz Cyzowski12Grzegorz Brożek13Maciej Dyrbuś14Szymon Skoczyński15Department of Internal Medicine and Metabolic DiseasesStudent Scientific SocietyStudent Scientific SocietyStudent Scientific SocietyStudent Scientific SocietyDepartment of Lung Diseases and Tuberculosis1st Department of Lung Diseases and TuberculosisDepartment of Anaesthesiology and Intensive CareDepartment of Lung Diseases and TuberculosisEmergency DepartmentEmergency DepartmentFirst Chair and Department of CardiologyDepartment of Anaesthesiology and Intensive CareDepartment of Epidemiology3rd Department of CardiologyDepartment of Lung Diseases and TuberculosisObjective. An accurate identification of patients at the need for prioritized diagnostics and care are crucial in the emergency department (ED). Blood gas (BG) analysis is a widely available laboratory test, which allows to measure vital parameters, including markers of ventilation and perfusion. The aim of our analysis was to assess whether blood gas parameters in patients with dyspnea at an increased risk of respiratory failure admitted to the ED can predict short-term outcomes. Methods. The study group eventually consisted of 108 patients, with available BG analysis. The clinical and laboratory parameters were retrospectively evaluated, and three groups were distinguished—arterial blood gas (ABG), venous blood gas (VBG), and mixed blood gas. The primary endpoint was short-term, all-cause mortality during the follow-up of median (quartile 1–quartile 3) 2 (1–4) months. The independent risk factors for mortality that could be obtained from blood gas sampling were evaluated. Results. The short-term mortality was 35.2% (38/108). Patients who died were more frequently initially assigned to the red triage risk group, more burdened with comorbidities, and the median SpO2 on admission was significantly lower than in patients who survived the follow-up period. In the multivariable analysis, lactate was the strongest independent predictor of death, with 1 mmol/L increasing all-cause mortality by 58% in ABG (95% CI: 1.01–2.47), by 80% in VBG (95% CI: 1.13–2.88), and by 68% in the mixed blood gas analysis (95% CI: 1.22–2.31), what remained significant in VBG and mixed group after correction for base excess. In each group, pH, pO2, and pCO2 did not predict short-term mortality. Conclusions. In patients admitted to the ED due to dyspnea, at risk of respiratory failure, lactate levels in arterial, venous, and mixed blood samples are independent predictors of short-term mortality.http://dx.doi.org/10.1155/2024/6624423 |
| spellingShingle | Maciej Niczewski Szymon Gawęda Paulina Kluszczyk Mikołaj Rycerski Daria Syguła Anna Danel Szymon Szmigiel Konrad Mendrala Aleksandra Oraczewska Czarosław Kijonka Monika Nowicka Michał Wita Tomasz Cyzowski Grzegorz Brożek Maciej Dyrbuś Szymon Skoczyński The Predictive Role of Lactate in the Emergency Department in Patients with Severe Dyspnea Emergency Medicine International |
| title | The Predictive Role of Lactate in the Emergency Department in Patients with Severe Dyspnea |
| title_full | The Predictive Role of Lactate in the Emergency Department in Patients with Severe Dyspnea |
| title_fullStr | The Predictive Role of Lactate in the Emergency Department in Patients with Severe Dyspnea |
| title_full_unstemmed | The Predictive Role of Lactate in the Emergency Department in Patients with Severe Dyspnea |
| title_short | The Predictive Role of Lactate in the Emergency Department in Patients with Severe Dyspnea |
| title_sort | predictive role of lactate in the emergency department in patients with severe dyspnea |
| url | http://dx.doi.org/10.1155/2024/6624423 |
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