| Admission hyperlactatemia: Causes, incidence, and impact on outcome of patients admitted in a general medical intensive care unit. | |
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MedLine Citation:
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PMID: 21255970 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: The aim of this study was to evaluate the causes, incidence, and impact on outcome of admission hyperlactatemia in patients admitted to a general medical intensive care unit (ICU). METHODS: A retrospective cohort study was done in an 8-bed general ICU of tertiary care hospital over 15 months. Data regarding patient demographics, probable cause of hyperlactatemia, presence of shock, need for organ support, and ICU outcome were recorded. Patients were divided into 2 groups based on admission lactate levels as follows: high lactate (>2 mmol/L) and normal lactate (<2 mmol/L). Patients were compared in terms of need for organ support and ICU mortality. RESULTS: Admission hyperlactatemia was present in 199 of 653 (30.47%) patients. Shock was the commonest cause, 53.3% patients, followed by respiratory and renal failure in 26 (13.1%) and 16 (8%) patients, respectively. Mean ± SD lactate levels in survivors and nonsurvivors were 1.64 ± 1.56 and 4.77 ± 4.72 mmol/L, respectively (P = .000). Receiver operating characteristic curve for lactate was 0.803 (95% confidence interval [CI], 0.753-0.853). Sensitivity and specificity of lactate (>2 mmol/L) to predict ICU mortality was 74.8% and 77.8%, respectively. Odds ratio for dying in patients with hyperlactatemia was 10.39 (95% CI, 6.378-16.925) with a relative risk of 1.538 (95% CI, 1.374-1.721). On subgroup analysis, in patients without hypotension too, ICU mortality was significantly increased in patients with hyperlactatemia (1.3% vs 6.45%, P = .009). CONCLUSIONS: Admission hyperlactatemia is common in a general ICU and is associated with increased mortality, irrespective of presence of hypotension. Shock was the commonest cause for hyperlactatemia, followed by respiratory and renal failures. |
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Authors:
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Deven Juneja; Omender Singh; Rohit Dang |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-1-19 |
Journal Detail:
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Title: Journal of critical care Volume: - ISSN: 1557-8615 ISO Abbreviation: - Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-1-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8610642 Medline TA: J Crit Care Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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