Observational studyPrehospital emergency care
Pre-resuscitation lactate and hospital mortality in prehospital patients.
Observational study in Prehospital emergency care. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- The use and impact of prehospital blood lactate measurements in acute non-traumatic patients: a systematic review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Pooled it
- Diagnostic value of prehospital arterial blood gas measurements - a randomised controlled trial.Scandinavian journal of trauma, resuscitation and emergency medicine · 2019Trial
- Prehospital lactate, transfer time, and early mortality across emergency diagnostic categories.Critical care (London, England) · 2026Observational
- Admission Blood Glucose Level with a Cutoff Value of 15 mmol/L Is a Reliable Predictor of Mortality in Polytraumatized Patients-a Prospective, Observational, Longitudinal Study From a North African Level One Trauma Center.Orthopedic research and reviews · 2025Article
- Added predictive value of prehospital measurement of point-of-care lactate in an adult general EMS population in Sweden: a multi-centre observational study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Observational
- Predictive parameters for early detection of clinically relevant abdominal trauma in multiple-injury or polytraumatised patients: a retrospective analysis.European journal of medical research · 2024Article
- Identifying trigger cues for hospital blood transfusions based on ensemble of machine learning methods.International journal of emergency medicine · 2024Article
- Identifying Trigger Cues for Hospital Blood Transfusions Based on Ensemble Learning Methods.Research square · 2024Article
- Prehospital blood gas analyses in acute patients treated by a ground-based physician-manned emergency unit: a cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Article
- Prevalence and clinical significance of point of care elevated lactate at emergency admission in older patients: a prospective study.Internal and emergency medicine · 2022Article
- Pre-hospital suPAR, lactate and CRP measurements for decision-making: a prospective, observational study of patients presenting non-specific complaints.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Observational
- Socio-demographic characteristics and pre-hospital care of children with circulatory failure in a children's emergency room in southern Nigeria.The Pan African medical journal · 2021Article
- Evaluation and prognostic value of Cv-aCOExperimental and therapeutic medicine · 2019Article
- Prehospital Lactate Predicts Need for Resuscitative Care in Non-hypotensive Trauma Patients.The western journal of emergency medicine · 2018Article
- Independent early predictors of mortality in polytrauma patients: a prospective, observational, longitudinal study.Clinics (Sao Paulo, Brazil) · 2017Observational
- Delays From First Medical Contact to Antibiotic Administration for Sepsis.Critical care medicine · 2017Article
- Prehospital Lactate Measurement by Emergency Medical Services in Patients Meeting Sepsis Criteria.The western journal of emergency medicine · 2016Article
- County-Level Effects of Prehospital Regionalization of Critically Ill Patients: A Simulation Study.Critical care medicine · 2015Article
- Comparison of Noninvasive pH and Blood Lactate as Predictors of Mortality in a Swine Hemorrhagic Shock with Restricted Volume Resuscitation Model.Shock (Augusta, Ga.) · 2015Article
- Hydrogen Gas Alleviates the Intestinal Injury Caused by Severe Sepsis in Mice by Increasing the Expression of Heme Oxygenase-1.Shock (Augusta, Ga.) · 2015Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 2 countries.
Funding
Abstract
objectiveSerum lactate elevations are associated with morbidity and mortality in trauma patients, but their value in prehospital medical patients prior to resuscitation is unknown. We sought to assess the distribution of blood lactate concentrations prior to intravenous (i.v.) resuscitation and examine the association of elevation on in-hospital death.
methodsA convenience sample of adult patients over 14 months who received an i.v. line by eight EMS agencies in Western Pennsylvania had lactate measurement prior to any i.v. treatment. We assessed the lactate values and any relationship between these and hospital mortality (our primary outcome) and admission to the intensive care unit (ICU). We also compared the ability of lactate to discriminate outcomes with a prehospital critical illness score using age, Glasgow Coma Score, and initial vital signs.
resultsWe included 673 patients, among whom 71 (11%) were admitted to the ICU and 21 (3.1%) died in-hospital. Elevated lactate (≥2 mmol/L) occurred in 307 (46%) patients and was strongly associated with hospital death after adjustment for known covariates (odds ratio = 3.57, 95% confidence interval [CI]: 1.10, 11.6). Lactate ≥2 mmol/L had a modest sensitivity (76%) and specificity (55%), and discrimination for hospital death (area under the curve [AUC] = 0.66, 95%CI: 0.56, 0.75). Compared to the prehospital critical illness score alone (AUC = 0.69, 95% CI: 0.59, 0.80), adding lactate to the score offered modest improvement (net reclassification improvement = 0.63, 95%CI: 0.23, 1.01, p < 0.05).
conclusionsInitial lactate concentration in our prehospital medical patient population was associated with hospital mortality. However, it is a modest predictor of outcome, offering similar discrimination to a prehospital critical illness score.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.