ArticleThe western journal of emergency medicine2018
Prehospital Lactate Predicts Need for Resuscitative Care in Non-hypotensive Trauma Patients.
Article in The western journal of emergency medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Criteria for trauma team activation and staffing requirements for the management of patients with (suspected) multiple and/or severe injuries in the resuscitation room- a systematic review and clinical practice guideline update.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- The potential of point-of-care diagnostics to optimise prehospital trauma triage: a systematic review of literature.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Pooled it
- Prehospital point-of-care lactate for identification of severe injury in trauma team-activated patients: a prospective multicenter cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Observational
- Serial Lactate in Clinical Medicine - A Narrative Review.Journal of intensive care medicine · 2026Review
- Review
- Biomarkers help identify critically injured patients with only moderate risk of severe injuries in trauma team activation.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Prognostic Value of Lactate Levels in Trauma Patients' Outcomes in Emergency Department.Bulletin of emergency and trauma · 2025Article
- 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
- Accuracy of a Prehospital Triage Protocol in Predicting In-Hospital Mortality and Severe Trauma Cases among Older Adults.International journal of environmental research and public health · 2023Article
- Elevated serum lactate levels and age are associated with an increased risk for severe injury in trauma team activation due to trauma mechanism.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Routine laboratory parameters predict intensive care unit admission and hospitalization in patients suffering stab injuries.Frontiers in immunology · 2022Article
- Clinical characteristics and course of out-of-hospital shock in a national emergency medical services cohort.Journal of the American College of Emergency Physicians open · 2020Article
- The FASILA Score: A Novel Bio-Clinical Score to Predict Massive Blood Transfusion in Patients with Abdominal Trauma.World journal of surgery · 2020Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe prehospital decision of whether to triage a patient to a trauma center can be difficult. Traditional decision rules are based heavily on vital sign abnormalities, which are insensitive in predicting severe injury. Prehospital lactate (PLac) measurement could better inform the triage decision. PLac's predictive value has previously been demonstrated in hypotensive trauma patients but not in a broader population of normotensive trauma patients transported by an advanced life support (ALS) unit.
methodsThis was a secondary analysis from a prospective cohort study of all trauma patients transported by ALS units over a 14-month period. We included patients who received intravenous access and were transported to a Level I trauma center. Patients with a prehospital systolic blood pressure ≤ 100 mmHg were excluded. We measured PLac's ability to predict the need for resuscitative care (RC) and compared it to that of the shock index (SI). The need for RC was defined as either death in the emergency department (ED), disposition to surgical intervention within six hours of ED arrival, or receipt of five units of blood within six hours. We calculated the risk associated with categories of PLac.
resultsAmong 314 normotensive trauma patients, the area under the receiver operator characteristic curve for PLac predicting need for RC was 0.716, which did not differ from that for SI (0.631) (p=0.125). PLac ≥ 2.5 mmol/L had a sensitivity of 74.6% and a specificity of 53.4%. The odds ratio for need for RC associated with a 1-mmol/L increase in PLac was 1.29 (95% confidence interval [CI] [0.40 - 4.12]) for PLac < 2.5 mmol/L; 2.27 (1.10 - 4.68) for PLac from 2.5 to 4.0 mmol/L; and 1.26 (1.05 - 1.50) for PLac ≥ 4 mmol/L.
conclusionPLac was predictive of need for RC among normotensive trauma patients. It was no more predictive than SI, but it has certain advantages and disadvantages compared to SI and could still be useful. Prospective validation of existing triage decision rules augmented by PLac should be investigated.
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