Observational studyAnnals of emergency medicine2018
Prognostic Utility of Initial Lactate in Patients With Acute Drug Overdose: A Validation Cohort.
Observational study in Annals of emergency medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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.
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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.
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Who cites it
11 citing papers in PubMed, 22 citations in OpenAlex.
- Acid-Base Phenotypes in Sedative Toxidrome: Characterisation, Agent-Specific Patterns and Clinical Associations.Emergency medicine Australasia : EMA · 2026Article
- Predicting adverse cardiovascular events in emergency department patients with bupropion overdose.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024Article
- Cocaethylene cardiotoxicity in emergency department patients with acute drug overdose.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Article
- Lactate for Predicting the Prognosis of Multi-Drug Poisoned Patients.Ethiopian journal of health sciences · 2023Article
- Time-Dependent Changes in the Serum Levels of Neurobiochemical Factors After Acute Methadone Overdose in Adolescent Male Rat.Cellular and molecular neurobiology · 2021Article
- Development and validation of new poisoning mortality score system for patients with acute poisoning at the emergency department.Critical care (London, England) · 2021Article
- An analysis of 1344 consecutive acute intoxication cases admitted to an academic emergency medicine department in Turkey.Northern clinics of Istanbul · 2021Article
- First-Line Vasopressor and Mortality Rates in ED Patients with Acute Drug Overdose.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2021Observational
- Incidence and risk factors for hyperlactatemia in ED patients with acute metformin overdose.The American journal of emergency medicine · 2019Observational
- A Review on Ingested Cyanide: Risks, Clinical Presentation, Diagnostics, and Treatment Challenges.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2019Review
- Outcome in intoxicated patients transported by a physician-staffed helicopter in Japan from 2015 to 2020.Acute medicine & surgeryArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
STUDY
objectivePrevious studies have suggested that the initial emergency department (ED) lactate concentration may be an important prognostic indicator for inhospital mortality from acute drug poisoning. We conduct this cohort study to formally validate the prognostic utility of the initial lactate concentration in a larger, distinct patient population with acute drug overdose.
methodsThis observational, prospective, cohort study was conducted during 5 years at 2 urban teaching hospitals. Consecutive adult ED patients with acute drug overdose had serum lactate levels tested as part of clinical care. The primary outcome was inpatient fatality. Receiver operating characteristics were plotted to determine optimal cut points, test characteristics, area under the curve, odds ratios, and 95% confidence intervals (CIs).
resultsOf 3,739 patients screened, 1,406 were analyzed (56% women; mean age 43.1 years) and 24 died (1.7%). The difference in mean initial lactate concentration was 5.9 mmol/L (95% CI 3.4 to 8.1 mmol/L) higher in patients who died compared with survivors. The area under the curve for prediction of fatality was 0.85 (95% CI 0.73 to 0.95). The optimal lactate cut point for fatality was greater than or equal to 5.0 (odds ratio 34.2; 95% CI 13.7 to 84.2; 94.7% specificity). Drug classes for which lactate had the highest utility were salicylates, sympathomimetics, acetaminophen, and opioids (all area under the curve ≥0.97); lowest utility was for diuretics and angiotensin-converting enzyme inhibitors.
conclusionInitial lactate concentration is a useful biomarker for early clinical decisionmaking in ED patients with acute drug overdose. Studies of lactate-tailored management for these patient populations are warranted.
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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.