Evidence map›Paper›PMID 35678940›Full record

ArticleInternal and emergency medicine2022

Prevalence and clinical significance of point of care elevated lactate at emergency admission in older patients: a prospective study.

Mélanie Gosselin, Cédric Mabire, Mathieu Pasquier, Pierre-Nicolas Carron, Olivier Hugli, Françcois-Xavier Ageron, Fabrice Dami

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Article in Internal and emergency medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mélanie GosselinEmergency Department, Lausanne University Hospital, University of Lausanne, 1011, Lausanne, Switzerland.
Cédric MabireInstitute of Higher Education and Research in Healthcare, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Mathieu PasquierEmergency Department, Lausanne University Hospital, University of Lausanne, 1011, Lausanne, Switzerland.
Pierre-Nicolas CarronEmergency Department, Lausanne University Hospital, University of Lausanne, 1011, Lausanne, Switzerland.
Olivier HugliEmergency Department, Lausanne University Hospital, University of Lausanne, 1011, Lausanne, Switzerland.
Françcois-Xavier AgeronEmergency Department, Lausanne University Hospital, University of Lausanne, 1011, Lausanne, Switzerland.
Fabrice DamiEmergency Department, Lausanne University Hospital, University of Lausanne, 1011, Lausanne, Switzerland. fabrice.dami@chuv.ch.ORCID 0000-0002-6994-4478

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePatients who are over 65 years old represent up to 24% of emergency department (ED) admissions. They are at increased risk of under-triage due to impaired physiological responses. The primary objective of this study was to assess the prevalence of elevated lactate by point of care testing (POCT) in this population. The secondary objective was to assess the additional value of lactate level in predicting an early poor outcome, as compared to and combined with common clinical scores and triage scales.

methodsThis monocentric prospective study recruited ED patients who were over 65 years old between July 19th 2019 and June 17th 2020. Patients consulting for seizures or needing immediate assessment were excluded. POCT lactates were considered elevated if ≥ 2.5 mmol/L. A poor outcome was defined based on certain complications or therapeutic decisions.

resultsIn total, 602 patients were included; 163 (27.1%) had elevated lactate and 44 (7.3%) had a poor outcome. There was no association between poor outcome and lactate level. Modified Early Warning Score (MEWS) was significantly associated with poor outcome, alongside National Early Warning Score (NEWS). Logistic regression also associated lactate level combined with MEWS and poor outcome.

conclusionThe prevalence of elevated lactate was 27.1%. Lactate level alone or combined with different triage scales or clinical scores such as MEWS, NEWS and qSOFA was not associated with prediction of a poor outcome. MEWS alone performed best in predicting poor outcome. The usefulness of POCT lactate measurement at triage is questionable in the population of 65 and above.

Indexed as

Point-of-Care SystemsSepsisAgedEmergency Service, HospitalHospital MortalityHumansLactic AcidPrevalenceProspective StudiesRetrospective StudiesROC CurveLactic AcidEmergencyLactateMEWSNEWSOlder peoplePoint-of-carePoor outcomeqSOFA

Identifiers

PMID35678940
PMCPMC9178320

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